Mp07-12 pelvic floor support following female radical cystectomy: a longitudinal observational study

You have accessJournal of UrologyCME1 Apr 2023MP07-12 PELVIC FLOOR SUPPORT FOLLOWING FEMALE RADICAL CYSTECTOMY: A LONGITUDINAL OBSERVATIONAL STUDY Shree Agrawal-Patel, Sandip Vasavada, David Rapp, Sarah Martin, Lauren Gleich, Tracey Krupski, Byron Lee, and Jacqueline Zillioux Shree Agrawal-PatelShree Agrawal-Patel More articles by this author , Sandip VasavadaSandip Vasavada More articles by this author , David RappDavid Rapp More articles by this author , Sarah MartinSarah Martin More articles by this author , Lauren GleichLauren Gleich More articles by this author , Tracey KrupskiTracey Krupski More articles by this author , Byron LeeByron Lee More articles by this author , and Jacqueline ZilliouxJacqueline Zillioux More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003222.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Women are at risk of pelvic organ prolapse and sexual dysfunction following radical cystectomy (RC); however, these outcomes are under-appreciated and understudied. We aimed to assess the natural history of pelvic floor support and vaginal symptoms following female RC. METHODS: This is an interim analysis of an IRB-approved multicenter prospective observational study of pelvic floor support in women undergoing RC from 3/2021 to 5/2022. All women undergoing RC at 2 institutions were recruited. Participants underwent pelvic exam including Pelvic Organ Prolapse Quantification System (POP-Q) measurements by an FPMRS-trained urologist at baseline and routine postoperative visits. Participants completed validated questionnaires (Pelvic Floor Disability Index (PFDI-20); International Consultation on Incontinence Questionnaire Vaginal Symptoms (ICIQ-VS)) at each visit. Surgical details including amount of vaginal tissue removed during non-vaginal-sparing RC were recorded. RESULTS: Fourteen women enrolled and had at least one postoperative visit through 6-months. Median age was 69 years. Approach was robotic in n=9 (64%) and vaginal-sparing in n=5 (38%). Indication was benign for 3 patients and all underwent non-orthotopic diversion. One vaginal-sparing benign case had concomitant mesh sacrocolpopexy for baseline stage 3 apical prolapse, while one patient from sparing and non-sparing groups had concurrent uterosacral ligament plication. All non-vaginal-sparing cases had clamshell reconstruction following excision of a median of 4.0 [4.0, 6.0] cm length and 2.5 [2.0, 4.0] cm width vaginal tissue, representing median 48% of baseline total vaginal length removed. Table 1 illustrates longitudinal POP-Q exam and questionnaire scores of vaginal sparing and non-sparing cases. One patient had anterior vaginal wall dehiscence requiring debridement under anesthesia but ultimately not reconstruction. CONCLUSIONS: To our knowledge, this is the first prospective study of pelvic floor support following female RC. Though further study is needed, preliminary findings through 6-month follow-up suggest vaginal foreshortening in both vaginal-sparing and non-sparing cases. Both groups appear to have mild anterior/posterior prolapse progression, although without worsened symptom scores. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e89 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Shree Agrawal-Patel More articles by this author Sandip Vasavada More articles by this author David Rapp More articles by this author Sarah Martin More articles by this author Lauren Gleich More articles by this author Tracey Krupski More articles by this author Byron Lee More articles by this author Jacqueline Zillioux More articles by this author Expand All Advertisement PDF downloadLoading ...