Your browser doesn't support javascript.
loading
Robotic simple cystectomy as a last resort for antibiotic-recalcitrant recurrent urinary tract infections in women.
Carlton, Caitlin E; Christie, Alana L; Prokesch, Bonnie C; Chao, Tze-Chen; Carmel, Maude E; Lemack, Gary E; Goueli, Ramy; Margulis, Vitaly; Zimmern, Philippe E.
Affiliation
  • Carlton CE; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Caitlin.Carlton@UTSouthwestern.edu.
  • Christie AL; Simmons Comprehensive Cancer Center, Biostatistics, University of Texas, Southwestern Medical Center, Dallas, TX. Electronic address: Alana.Christie@UTSouthwestern.edu.
  • Prokesch BC; Department of Infectious Disease, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Bonnie.Prokesch@UTSouthwestern.edu.
  • Chao TC; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Tze-Chen.Chao@UTSouthwestern.edu.
  • Carmel ME; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Maude.Carmel@UTSouthwestern.edu.
  • Lemack GE; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Gary.Lemack@UTSouthwestern.edu.
  • Goueli R; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Ramy.Goueli@UTSouthwestern.edu.
  • Margulis V; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Vitaly.Margulis@UTSouthwestern.edu.
  • Zimmern PE; Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX. Electronic address: Philippe.Zimmern@UTSouthwestern.edu.
Urology ; 186: 139-143, 2024 04.
Article de En | MEDLINE | ID: mdl-38395078
ABSTRACT

OBJECTIVE:

To report a series of women with antibiotic-recalcitrant recurrent urinary tract infections (rUTI) managed with robotic simple cystectomy and ileal conduit urinary diversion.

METHODS:

Following Institutional Review Board approval, all female patients who underwent robotic cystectomy for rUTI between 2011 and 2021 were identified from a prospectively-maintained internal database at a tertiary care center. Exclusion criteria included interstitial cystitis, neurogenic bladder, urinary tract neoplasm, or congenital abnormality. Electronic medical records were reviewed by an independent researcher. Patients were also administered the Quality of Life Questionnaire-C30.

RESULTS:

Twenty-four patients met inclusion criteria. Median age was 75 years (range 53-87). Median rUTI duration was 6 (interquartile range [IQR] 2-10) years. Median urinary tract infections count in the 12-month preceding cystectomy was 5 (IQR 3-9). Infections with multidrug resistant organisms were found in 21 patients (88%). The 30-day postoperative complication rate was 79% (19/24), of which 11% were Clavien-Dindo grade ≥III. The main late complication was parastomal hernia, with 17% requiring repair or revision. At a median of 36 months (range 12-61) post-operatively, the median Quality of Life Questionnaire-C30 global health status score was 50 (range 33-83).

CONCLUSION:

Cystectomy is a last-resort management option for women with severely symptomatic end-stage bladders in the setting of antibiotic-recalcitrant rUTI. Patients should be counseled thoroughly regarding possible acute and long-term postoperative complications. Select patients, managed in high-volume referral centers, can benefit from robotic simple cystectomy with ileal conduit urinary diversion.
Sujet(s)

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Dérivation urinaire / Infections urinaires / Tumeurs de la vessie urinaire / Interventions chirurgicales robotisées Limites: Aged / Aged80 / Female / Humans / Middle aged Langue: En Journal: Urology Année: 2024 Type de document: Article

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Dérivation urinaire / Infections urinaires / Tumeurs de la vessie urinaire / Interventions chirurgicales robotisées Limites: Aged / Aged80 / Female / Humans / Middle aged Langue: En Journal: Urology Année: 2024 Type de document: Article
...