Assessment of voiding function of orthotopic neobladders in elderly patients with long-term survival.

Objective: To compare the voiding status in elderly patients (aged >or=80 years) with that in younger patients undergoing orthotopic neobladder substitution during long-term survival.

Patients And Methods: The voiding status was assessed in 111 patients (ileal neobladder in 62, ascending colonic neobladder in 14, sigmoid colonic neobladder in 21 and ileocolonic neobladder in 14) who lived for >5 years after radical cystectomy with an orthotopic neobladder, using a self-completed questionnaire and uroflowmetry. According to the age at the time of these assessments, patients were divided into two groups (group 1, <80 years, 94; group 2, >or=80 years, 17). The voiding status was compared between the groups.

Results: In all, 78 patients (92%) in group 1 and 16 (94%) in group 2 were capable of spontaneous voiding. In group 1 and 2, respectively, daytime continence was achieved by 67 (74%) and 12 (75%) patients, but night-time continence was achieved by 54 (60%) and six (38%), although the difference was not statistically significant. In groups 1 and 2, respectively, the median maximum flow rate was 13.3 and 11.7 mL/s and the median postvoid residual urine volume was 19 and 18 mL. The only statistically significant difference was for voiding posture, assessed in men.

Conclusions: There was no significant difference in voiding status of patients with orthotopic neobladders except for voiding posture between patients aged <80 or carefully selected elderly patients aged >or=80 years during long-term survival. However, night-time continence might be clinically worse in the elderly than in the younger group.