LAUSR

OBJECTIVES To assess long-term voiding and renal function (RF) changes after radical cystectomy (RC) and orthotopic neobladder (ONB) in females without disease recurrence. MATERIAL AND METHODS Female patients who underwent RC and ONB from 1995 and 2011 were included. Patients who developed disease failure or lost follow-up were excluded. The study outcomes were long-term voiding function and the incidence and predictors of RF deterioration (defined by > 20% decline of baseline). Analysis was performed using the log-rank test and Cox regression analysis. RESULTS The study included 195 patients with a median (IQR) follow-up of 98 (53-151) months of whom 95 had > 10 years of follow-up. Daytime, night-time continence, and chronic urine retention (CUR) were identified in 170 (87%), 134 (69%) and 52 (27%) patients, respectively. Among patients with >10 years of follow-up, 82 (86%), 66 (70%), and 31 (33%) had daytime, night-time continence, and CUR at the last follow-up visit, respectively. Renal function deterioration events occurred in 74 patients through the follow-up and CKD stage III-V developed in 80 patients. Patients' age [HR (95%CI): 1.41 (1.06-1.89), p=0.02], and serous-lined extramural tunnel (SLET) diversion [HR (95%CI): 0.43 (0.19-0.86), p=0.02] were the independent predictors of RF deterioration. Among patients with >10 years of follow-up, RF deteriorated in 46 (49%) patients and CKD stage III-V developed in 40 (42%). CONCLUSION Females surviving more than 10 years after RC and ONB had maintained acceptable continence status apart from a higher CUR rate compared to those followed for < 10 years. Yet, renal function deterioration developed in nearly half of them.