Urodynamic predictors of daytime and nighttime urinary incontinence in FloRIN and Padua intracorporeal robotic neobladders: Results from two tertiary-care centers at mid-term follow-up
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Functional results of intracorporeal orthotopic ileal neobladders (iOINs) may vary depending on the selected neobladder technique. Standardization in reporting continence outcomes is lacking, as objective measurements based on urodynamic assessment remain limited. The aim of this series was to identify urodynamic predictors of daytime and nighttime urinary incontinence for robotic iOINs performed at 2 high-volume centers. Materials and methods: We retrospectively pooled data from two prospectively maintained institutional robot-assisted radical cystectomy databases covering the period from June 2017 to May 2023. The pooled dataset was queried to identify patients who underwent iOIN reconstruction and completed urodynamic evaluation, yielding a final study population of 94 patients. Baseline data and complete urodynamic profiles were collected. Urodynamic assessment was performed between 6 and 9 months after surgery. Frequencies and proportions were reported for categorical variables, while medians and interquartile ranges were reported for continuous variables. Univariable and multivariable logistic regression analyses were used to identify predictors of daytime and nighttime urinary incontinence at last follow-up. Multicollinearity among covariates initially considered for multivariable modeling was assessed using variance inflation factor analysis. A 2-sided p < 0.05 was considered statistically significant. Results: Overall, at a median follow-up of 25 months (interquartile range, 15.5–37.5), 94 patients achieved a complete urodynamic evaluation. On multivariable analysis, female gender (OR, 4.14; 95% CI, 1.37–12.5; p = 0.01) was the only independent predictor of daytime urinary incontinence, whereas cystometric capacity <250 mL showed an association at univariable analysis only and was not retained after multivariable adjustment. Residual peristaltic neobladder activity (OR, 3.44; 95% CI, 1.02–11.5; p = 0.04) was the only independent predictor of nighttime urinary incontinence. Conclusions: At urodynamic evaluation, female gender emerged as the only independent predictor of daytime urinary incontinence, whereas residual peristaltic neobladder activity was the only independent predictor of nighttime urinary incontinence. Urodynamic assessment may provide clinically relevant insights into continence evolution after iOIN at mid-term follow-up.
Source: Current Urology
Authors: Umberto Anceschi, Fabrizio Di Maida, Giuseppe Chiacchio, Riccardo Mastroianni, Gabriele Tuderti, Luca Lambertini, Simone Albisinni, Manuela Mattioli, Sara Costagli, Rocco Simone Flammia, Samuele Nardoni, Antonio Minore, Eleonora Rosato, Daniele Paganelli, Aldo Brassetti, Marco Saladino, Anastasios Asimakopoulos, Vincenzo Salamone, Salvatore Basile, Sofia Giudici, D’Ippolito Giulia, Antonio Andrea Grosso, Antonio Tufano, Leslie Licari, Eugenio Bologna, Andrea Mari, Agostino Tuccio, Agrò Enrico Finazzi, Cosimo De Nunzio, Costantino Leonardo, Andrea Minervini, Giuseppe Simone
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7128490093