Urodynamic predictors of daytime and nighttime urinary incontinence in Florence robotic intracorporeal neobladder and Padua intracorporeal robotic neobladder: Results from 2 tertiary care centers at midterm follow-up

Background: Functional outcomes of intracorporeal orthotopic ileal neobladders (iOINs) may vary depending on the robotic technique used. However, standardized reporting of continence outcomes remains limited, as objective measurements through urodynamic assessment continue to pose challenges. This study aimed to identify urodynamic predictors of daytime and nighttime urinary incontinence in patients who underwent robotic iOIN at 2 high-volume centers. Materials and methods: Between June 2017 and May 2023, 2 prospective robot-assisted radical cystectomy datasets were merged and queried for “iOIN” and “urodynamic evaluation” (n = 94). Baseline characteristics and complete urodynamic profiles were collected. Urodynamic assessments were conducted 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. Logistic regression analyses were performed to identify predictors of daytime and nighttime urinary continence at the last follow-up. For all analyses, a 2-sided p < 0.05 was considered statistically significant. Results: At a median follow-up of 25 months (interquartile range, 15.5–37.5), 94 patients completed urodynamic evaluations. On multivariable analysis, female sex (odds ratio [OR], 4.14; 95% confidence interval [CI], 1.37–12.5; p = 0.01) and compliance capacity <250 mL (OR, 0.33; 95% CI, 0.11–0.98; p = 0.04) were independent predictors of daytime urinary incontinence. 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, compliance capacity <250 mL and female sex were independent predictors of daytime urinary incontinence, while residual peristaltic neobladder activity predicted nighttime urinary incontinence, regardless of the iOIN technique used. Urodynamic assessment provides valuable insights into continence outcomes in patients with iOINs at midterm follow-up.