{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:48:09Z","timestamp":1759970889172,"version":"build-2065373602"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023392","name":"NIHR Barts Biomedical Research Centre, Queen Mary University of London","doi-asserted-by":"publisher","award":["NIHR203330"],"award-info":[{"award-number":["NIHR203330"]}],"id":[{"id":"10.13039\/501100023392","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>A range of techniques have been described for robotic\u2010assisted intracorporeal neobladder construction. The pyramid neobladder has now been performed for over 10\u00a0years. We now describe the long\u2010term outcomes, including the impact of function preservation through nerve and prostate capsule sparing in the male population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects\/Patients and Methods<\/jats:title><jats:p>All patients who underwent pyramid neobladder construction between January 2015 and December 2023 at the University College London Hospital (UK) were reviewed. Patients were selected for function preservation based on baseline sexual function\/wishes, PSA \u00b1 multiparametric prostate MRI. Selected oncological, functional and patient reported outcomes were assessed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 71 patients were included; 87% (61\/71) were men. About 65% (40\/61) underwent either nerve\u2010 or prostate capsule\u2010sparing surgery. Median follow\u2010up was 57.8\u00a0months (IQR 48.3). In male patients, there was no difference between the 12\u2010 and 24\u2010month cancer specific and overall survival rates between the function sparing groups. There were no positive prostate cancer margins. Daytime continence was 75% (39\/52) and 67% (6\/9), and nighttime was 17% (9\/52) and 11% (1\/9), in men and women, respectively. There was no significant difference between the male function sparing groups (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.342). About 94% of men (29\/31) were sexually active before surgery, falling to 55% (17\/31) after, with 76% (13\/17) using treatment for erectile dysfunction. The median change in SHIM score was 4.5 (SD 5.3) in prostate capsule\u2010sparing, 6 (SD 7.7) in nerve\u2010sparing and 17 (SD 2.8) in standard groups.<\/jats:p><jats:p>About 45% (30\/66) of patients had a significant reduction in eGFR (&gt;10\u00a0mL\/min\/1.73m<jats:sup>2<\/jats:sup>). Uretero\u2013ileal strictures were confirmed in 4.2% (3\/71). About 28% (19\/67) of patients reported recurrent UTIs and 7% (5\/71) reported neobladder rupture.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Sexual function had the largest impact on quality of life and may be improved with function\u2010sparing techniques. The burden of additional complications including neobladder rupture and urinary tract infections was also highlighted.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bco2.70062","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T01:39:33Z","timestamp":1754962773000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010term outcomes in patients with intracorporeal robot\u2010assisted pyramid neobladder"],"prefix":"10.1002","volume":"6","author":[{"given":"Elizabeth","family":"Day","sequence":"first","affiliation":[{"name":"Department of Urology University College London Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9579-6951","authenticated-orcid":false,"given":"Pratham","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Medical School University College London  London 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