Ileal conduit versus neobladder: A propensity score‐matched analysis of the effect on renal function
Objectives To analyze the long‐term effects of continent (neobladder) compared with incontinent (ileal conduit) urinary diversion. Methods We carried out a retrospective review of our departmental database. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemio...
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| Veröffentlicht in: | International journal of urology 2022-02, Vol.29 (2), p.158-163 |
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| creator | Iqbal, Umar Houenstein, Holly A Elsayed, Ahmed S Jing, Zhe James, Gaybrielle Hussein, Ahmed A Guru, Khurshid A |
| description | Objectives
To analyze the long‐term effects of continent (neobladder) compared with incontinent (ileal conduit) urinary diversion.
Methods
We carried out a retrospective review of our departmental database. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Neobladder and ileal conduit patients were matched in a 1:2 ratio and a propensity score‐matched analysis was carried out. Data were summarized using descriptive analysis. Trend plots were generated using baseline and follow‐up creatinine values to compare estimated glomerular filtration rate at 3 months, then annually for 5 years. Variables associated with estimated glomerular filtration rate were assessed using multivariate linear analysis.
Results
Our cohort consisted of 137 patients (neobladder n = 50 and ileal conduit n = 87) with a median follow‐up time of 3 years (interquartile range 1–7 years). The ileal conduit group had shorter operative times (352 vs 444 min, P |
| doi_str_mv | 10.1111/iju.14747 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2623075960</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2624985530</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3777-474ef7b956f96f40f3e687b6df28adfee7bdaecf91013b2e5e69fdbb576195b03</originalsourceid><addsrcrecordid>eNp1kLtOwzAUhi0EgnIZeAFkiQWGUNtx4pgNIS5FlVhgjnw5FqnSuNgJqBuPwDPyJLgUGJA4yxnOp1_n_xA6pOSMphk3s-GMcsHFBhpRzlnGCGebaEQklVlFBdtBuzHOCKE5o9U22sl5JSTPixFykxZUi43v7ND0-AVCHCLuwOtWWQvhHF_gRfAL6GLTL3E0PsDH2_tc9eYJLFadapexidg73D8BBufA9Nh3OEA6YTd0pm98t4-2nGojHHzvPfR4ffVweZtN728mlxfTzORCiCx1ACe0LEonS8eJy6GshC6tY5WyDkBoq8A4SVMVzaCAUjqrdSFKKgtN8j10ss5NPz8PEPt63kQDbatSpSHWrGQ5EYUsV-jxH3Tmh5Ce_qK4rIoiX1Gna8oEH2MAVy9CM1dhWVNSr-TXSX79JT-xR9-Jg56D_SV_bCdgvAZemxaW_yfVk7vHdeQnNB-QLQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2624985530</pqid></control><display><type>article</type><title>Ileal conduit versus neobladder: A propensity score‐matched analysis of the effect on renal function</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Iqbal, Umar ; Houenstein, Holly A ; Elsayed, Ahmed S ; Jing, Zhe ; James, Gaybrielle ; Hussein, Ahmed A ; Guru, Khurshid A</creator><creatorcontrib>Iqbal, Umar ; Houenstein, Holly A ; Elsayed, Ahmed S ; Jing, Zhe ; James, Gaybrielle ; Hussein, Ahmed A ; Guru, Khurshid A</creatorcontrib><description>Objectives
To analyze the long‐term effects of continent (neobladder) compared with incontinent (ileal conduit) urinary diversion.
Methods
We carried out a retrospective review of our departmental database. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Neobladder and ileal conduit patients were matched in a 1:2 ratio and a propensity score‐matched analysis was carried out. Data were summarized using descriptive analysis. Trend plots were generated using baseline and follow‐up creatinine values to compare estimated glomerular filtration rate at 3 months, then annually for 5 years. Variables associated with estimated glomerular filtration rate were assessed using multivariate linear analysis.
Results
Our cohort consisted of 137 patients (neobladder n = 50 and ileal conduit n = 87) with a median follow‐up time of 3 years (interquartile range 1–7 years). The ileal conduit group had shorter operative times (352 vs 444 min, P < 0.01), intracorporeal diversions were more common (66% vs 44%, P = 0.01), had prior abdominal surgery (66% vs 38%, P < 0.01) and had radiation (9% vs 0%, P = 0.03). The neobladder group more commonly had recurrent urinary tract infections (22% vs 3%, P < 0.01) and a steeper decrease in estimated glomerular filtration rate in the first year. On multivariate linear analysis, age/year (−0.59), body mass index per kg/m2 (−0.52), preoperative estimated glomerular filtration rate per unit (0.51), recurrent urinary tract infections (−14.03) and time versus day 90 (year 1, −7.52; year 2, −9.06; year 3, −10.78) were significantly associated with estimated glomerular filtration rate.
Conclusion
Ileal conduits and neobladders showed a similar effect on the estimated glomerular filtration rate up to 5 years after robot‐assisted radical cystectomy. Recurrent urinary tract infections were associated with a worse estimated glomerular filtration rate.</description><identifier>ISSN: 0919-8172</identifier><identifier>ISSN: 1442-2042</identifier><identifier>EISSN: 1442-2042</identifier><identifier>DOI: 10.1111/iju.14747</identifier><identifier>PMID: 34879435</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>bladder cancer ; Body mass index ; Creatinine ; Cystectomy - adverse effects ; diversion ; Epidemiology ; Glomerular filtration rate ; Humans ; ileal conduit ; Kidney - physiology ; Kidney - surgery ; Kidney diseases ; neobladder ; Patients ; Propensity Score ; radical cystectomy ; Renal function ; Urinary Bladder Neoplasms - surgery ; Urinary Diversion - adverse effects ; Urinary tract ; Urinary tract diseases ; Urinary tract infections ; Urogenital system</subject><ispartof>International journal of urology, 2022-02, Vol.29 (2), p.158-163</ispartof><rights>2021 The Japanese Urological Association</rights><rights>2021 The Japanese Urological Association.</rights><rights>2022 The Japanese Urological Association</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3777-474ef7b956f96f40f3e687b6df28adfee7bdaecf91013b2e5e69fdbb576195b03</citedby><cites>FETCH-LOGICAL-c3777-474ef7b956f96f40f3e687b6df28adfee7bdaecf91013b2e5e69fdbb576195b03</cites><orcidid>0000-0002-7132-4585 ; 0000-0002-4551-4676</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fiju.14747$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fiju.14747$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34879435$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iqbal, Umar</creatorcontrib><creatorcontrib>Houenstein, Holly A</creatorcontrib><creatorcontrib>Elsayed, Ahmed S</creatorcontrib><creatorcontrib>Jing, Zhe</creatorcontrib><creatorcontrib>James, Gaybrielle</creatorcontrib><creatorcontrib>Hussein, Ahmed A</creatorcontrib><creatorcontrib>Guru, Khurshid A</creatorcontrib><title>Ileal conduit versus neobladder: A propensity score‐matched analysis of the effect on renal function</title><title>International journal of urology</title><addtitle>Int J Urol</addtitle><description>Objectives
To analyze the long‐term effects of continent (neobladder) compared with incontinent (ileal conduit) urinary diversion.
Methods
We carried out a retrospective review of our departmental database. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Neobladder and ileal conduit patients were matched in a 1:2 ratio and a propensity score‐matched analysis was carried out. Data were summarized using descriptive analysis. Trend plots were generated using baseline and follow‐up creatinine values to compare estimated glomerular filtration rate at 3 months, then annually for 5 years. Variables associated with estimated glomerular filtration rate were assessed using multivariate linear analysis.
Results
Our cohort consisted of 137 patients (neobladder n = 50 and ileal conduit n = 87) with a median follow‐up time of 3 years (interquartile range 1–7 years). The ileal conduit group had shorter operative times (352 vs 444 min, P < 0.01), intracorporeal diversions were more common (66% vs 44%, P = 0.01), had prior abdominal surgery (66% vs 38%, P < 0.01) and had radiation (9% vs 0%, P = 0.03). The neobladder group more commonly had recurrent urinary tract infections (22% vs 3%, P < 0.01) and a steeper decrease in estimated glomerular filtration rate in the first year. On multivariate linear analysis, age/year (−0.59), body mass index per kg/m2 (−0.52), preoperative estimated glomerular filtration rate per unit (0.51), recurrent urinary tract infections (−14.03) and time versus day 90 (year 1, −7.52; year 2, −9.06; year 3, −10.78) were significantly associated with estimated glomerular filtration rate.
Conclusion
Ileal conduits and neobladders showed a similar effect on the estimated glomerular filtration rate up to 5 years after robot‐assisted radical cystectomy. Recurrent urinary tract infections were associated with a worse estimated glomerular filtration rate.</description><subject>bladder cancer</subject><subject>Body mass index</subject><subject>Creatinine</subject><subject>Cystectomy - adverse effects</subject><subject>diversion</subject><subject>Epidemiology</subject><subject>Glomerular filtration rate</subject><subject>Humans</subject><subject>ileal conduit</subject><subject>Kidney - physiology</subject><subject>Kidney - surgery</subject><subject>Kidney diseases</subject><subject>neobladder</subject><subject>Patients</subject><subject>Propensity Score</subject><subject>radical cystectomy</subject><subject>Renal function</subject><subject>Urinary Bladder Neoplasms - surgery</subject><subject>Urinary Diversion - adverse effects</subject><subject>Urinary tract</subject><subject>Urinary tract diseases</subject><subject>Urinary tract infections</subject><subject>Urogenital system</subject><issn>0919-8172</issn><issn>1442-2042</issn><issn>1442-2042</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kLtOwzAUhi0EgnIZeAFkiQWGUNtx4pgNIS5FlVhgjnw5FqnSuNgJqBuPwDPyJLgUGJA4yxnOp1_n_xA6pOSMphk3s-GMcsHFBhpRzlnGCGebaEQklVlFBdtBuzHOCKE5o9U22sl5JSTPixFykxZUi43v7ND0-AVCHCLuwOtWWQvhHF_gRfAL6GLTL3E0PsDH2_tc9eYJLFadapexidg73D8BBufA9Nh3OEA6YTd0pm98t4-2nGojHHzvPfR4ffVweZtN728mlxfTzORCiCx1ACe0LEonS8eJy6GshC6tY5WyDkBoq8A4SVMVzaCAUjqrdSFKKgtN8j10ss5NPz8PEPt63kQDbatSpSHWrGQ5EYUsV-jxH3Tmh5Ce_qK4rIoiX1Gna8oEH2MAVy9CM1dhWVNSr-TXSX79JT-xR9-Jg56D_SV_bCdgvAZemxaW_yfVk7vHdeQnNB-QLQ</recordid><startdate>202202</startdate><enddate>202202</enddate><creator>Iqbal, Umar</creator><creator>Houenstein, Holly A</creator><creator>Elsayed, Ahmed S</creator><creator>Jing, Zhe</creator><creator>James, Gaybrielle</creator><creator>Hussein, Ahmed A</creator><creator>Guru, Khurshid A</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7132-4585</orcidid><orcidid>https://orcid.org/0000-0002-4551-4676</orcidid></search><sort><creationdate>202202</creationdate><title>Ileal conduit versus neobladder: A propensity score‐matched analysis of the effect on renal function</title><author>Iqbal, Umar ; Houenstein, Holly A ; Elsayed, Ahmed S ; Jing, Zhe ; James, Gaybrielle ; Hussein, Ahmed A ; Guru, Khurshid A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3777-474ef7b956f96f40f3e687b6df28adfee7bdaecf91013b2e5e69fdbb576195b03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>bladder cancer</topic><topic>Body mass index</topic><topic>Creatinine</topic><topic>Cystectomy - adverse effects</topic><topic>diversion</topic><topic>Epidemiology</topic><topic>Glomerular filtration rate</topic><topic>Humans</topic><topic>ileal conduit</topic><topic>Kidney - physiology</topic><topic>Kidney - surgery</topic><topic>Kidney diseases</topic><topic>neobladder</topic><topic>Patients</topic><topic>Propensity Score</topic><topic>radical cystectomy</topic><topic>Renal function</topic><topic>Urinary Bladder Neoplasms - surgery</topic><topic>Urinary Diversion - adverse effects</topic><topic>Urinary tract</topic><topic>Urinary tract diseases</topic><topic>Urinary tract infections</topic><topic>Urogenital system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iqbal, Umar</creatorcontrib><creatorcontrib>Houenstein, Holly A</creatorcontrib><creatorcontrib>Elsayed, Ahmed S</creatorcontrib><creatorcontrib>Jing, Zhe</creatorcontrib><creatorcontrib>James, Gaybrielle</creatorcontrib><creatorcontrib>Hussein, Ahmed A</creatorcontrib><creatorcontrib>Guru, Khurshid A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iqbal, Umar</au><au>Houenstein, Holly A</au><au>Elsayed, Ahmed S</au><au>Jing, Zhe</au><au>James, Gaybrielle</au><au>Hussein, Ahmed A</au><au>Guru, Khurshid A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ileal conduit versus neobladder: A propensity score‐matched analysis of the effect on renal function</atitle><jtitle>International journal of urology</jtitle><addtitle>Int J Urol</addtitle><date>2022-02</date><risdate>2022</risdate><volume>29</volume><issue>2</issue><spage>158</spage><epage>163</epage><pages>158-163</pages><issn>0919-8172</issn><issn>1442-2042</issn><eissn>1442-2042</eissn><abstract>Objectives
To analyze the long‐term effects of continent (neobladder) compared with incontinent (ileal conduit) urinary diversion.
Methods
We carried out a retrospective review of our departmental database. Estimated glomerular filtration rate was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. Neobladder and ileal conduit patients were matched in a 1:2 ratio and a propensity score‐matched analysis was carried out. Data were summarized using descriptive analysis. Trend plots were generated using baseline and follow‐up creatinine values to compare estimated glomerular filtration rate at 3 months, then annually for 5 years. Variables associated with estimated glomerular filtration rate were assessed using multivariate linear analysis.
Results
Our cohort consisted of 137 patients (neobladder n = 50 and ileal conduit n = 87) with a median follow‐up time of 3 years (interquartile range 1–7 years). The ileal conduit group had shorter operative times (352 vs 444 min, P < 0.01), intracorporeal diversions were more common (66% vs 44%, P = 0.01), had prior abdominal surgery (66% vs 38%, P < 0.01) and had radiation (9% vs 0%, P = 0.03). The neobladder group more commonly had recurrent urinary tract infections (22% vs 3%, P < 0.01) and a steeper decrease in estimated glomerular filtration rate in the first year. On multivariate linear analysis, age/year (−0.59), body mass index per kg/m2 (−0.52), preoperative estimated glomerular filtration rate per unit (0.51), recurrent urinary tract infections (−14.03) and time versus day 90 (year 1, −7.52; year 2, −9.06; year 3, −10.78) were significantly associated with estimated glomerular filtration rate.
Conclusion
Ileal conduits and neobladders showed a similar effect on the estimated glomerular filtration rate up to 5 years after robot‐assisted radical cystectomy. Recurrent urinary tract infections were associated with a worse estimated glomerular filtration rate.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>34879435</pmid><doi>10.1111/iju.14747</doi><tpages>164</tpages><orcidid>https://orcid.org/0000-0002-7132-4585</orcidid><orcidid>https://orcid.org/0000-0002-4551-4676</orcidid></addata></record> |
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| ispartof | International journal of urology, 2022-02, Vol.29 (2), p.158-163 |
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| language | eng |
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| source | MEDLINE; Access via Wiley Online Library |
| subjects | bladder cancer Body mass index Creatinine Cystectomy - adverse effects diversion Epidemiology Glomerular filtration rate Humans ileal conduit Kidney - physiology Kidney - surgery Kidney diseases neobladder Patients Propensity Score radical cystectomy Renal function Urinary Bladder Neoplasms - surgery Urinary Diversion - adverse effects Urinary tract Urinary tract diseases Urinary tract infections Urogenital system |
| title | Ileal conduit versus neobladder: A propensity score‐matched analysis of the effect on renal function |
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