The following is a summary of “Perioperative outcomes and continence following robotic-assisted radical cystectomy with Mainz pouch II urinary diversion in patients with bladder cancer,” published in the January 2024 issue of Urology by Jing et al.

This study aims to disclose the less-explored perioperative outcomes and continence status among bladder cancer patients undergoing robotic-assisted radical cystectomy (RARC) with Mainz pouch II urinary diversion (UD). Examining data from November 2020 to December 2023, encompassing 37 patients, the researchers employed the RC-pentafecta criteria to evaluate results, considering parameters such as patient demographics, perioperative data, continence, and complications within early (≤ 30 days) and late (≤ 30 days) postoperative periods. The RC-pentafecta criteria involved the removal of ≥ 16 lymph nodes, negative soft tissue surgical margins, absence of major complications at 90 days, no clinical recurrence at ≤ 12 months, and absence of long-term UD-related sequelae. 

Utilizing a numeric rating scale and the Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire, the investigators assessed patient satisfaction with urinary continence and evaluated bowel function. Over a median follow-up of 23.0 months, 37 patients exhibited positive outcomes, with 83.8% achieving continence both during the day and at night. Notably, 94.6% expressed satisfaction with their urinary continence status, and 56.8% were very satisfied. 

The study revealed a median time to urinary continence after surgery of 2.3 months, with the mean voiding frequency being 6 during the day and 3 at night. Among the patients, 32.4% achieved RC-pentafecta, associated with better satisfaction scores (7.3 vs. 5.5, p = 0.034). The study found no significant difference in overall survival between RC-pentafecta and No RC-pentafecta groups (25.6 vs. 21.5 months, p = 0.16), and 19.4% experienced late complications. In conclusion, Mainz pouch II UD following RARC in bladder cancer patients demonstrated satisfactory continence rates, and achieving RC-pentafecta correlated with enhanced satisfaction. Given its reduced invasiveness, the intracorporeal approach to Mainz pouch II UD proved beneficial, particularly for female patients.

Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-024-11874-x