Salvage prostatectomy with bladder neck closure, continent catheterizable stoma and bladder augmentation: feasibility and patient reported continence outcomes at 32 months: De E, Pisters LL, Pettaway CA, Scott S, Westney OL, Division of Urology, Albany Me

Purpose e prostatectomy after radiation therapy is associated with a high rate of urinary incontinence. To avoid this outcome in candidates with pre-existing voiding symptoms, such as frequency, urgency, and urge incontinence, we performed concurrent bladder augmentation with bladder neck closure and a catheterizable stoma. Urinary incontinence and patient satisfaction were evaluated. als and Methods n October 2000 and February 2003, 11 patients underwent salvage prostatectomy with bladder neck closure and ileal augmentation using catheterizable appendicovesicostomy or Monti ileovesicostomy. Self-reported outcome measures included patient questionnaires and the validated Incontinence Symptom Index. s dication for surgery was recurrent adenocarcinoma of the prostate in 10 patients and invasive squamous cell carcinoma of the urethra in 1. All patients underwent prior radiation. Mean ± SD followup after prostatectomy and reconstruction was 32 ± 7.5 months. The physician noted that 8 of 11 patients (73%) were dry. Nine of 11 patients (82%) returned the questionnaire. Only 2 of 9 patients (22%) reported using absorbent protection. By self-report and the Incontinence Symptom Index, 4 of 9 patients (44%) reported no leakage and only 3 (33%) had leakage more frequently than once weekly. Three of 11 patients (27%) required stomal revision at an average of 24 ± 17 months, of whom 2 still reported difficult catheterization. Seven of 9 patients (77%) reported that they would repeat the procedure. sions ent catheterizable bladder augmentation is a technically feasible option for men requiring salvage prostatectomy. The postoperative continence rate is excellent and it appears superior to that in the literature for salvage prostatectomy with vesicourethral anastomosis.