{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:19:44Z","timestamp":1787717984319,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Despite highly standardized surgical procedures, approximately 20%\u201330% of patients develop postoperative paralytic ileus following radical cystectomy, representing the highest incidence among abdominopelvic surgeries. The objective of this study was to identify additional predictors of paralytic ileus in a large single\u2010centre cohort. Particular emphasis was placed on expanding the evidence regarding the effectiveness of advanced hemodynamic monitoring using the FloTrac\u00ae system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>We retrospectively analysed 383 patients and finally included 296 patients who underwent open or robotic radical cystectomy between 2018 and 2024 at our centre. Of these, 49 patients (16.6%) received intraoperative, minimal invasive FloTrac\u00ae monitoring. Perioperative variables were compared between groups, and predictors of paralytic ileus were determined using univariable and multivariable logistic regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Paralytic ileus occurred in 23.0% of patients overall, with a significantly lower incidence in the FloTrac\u00ae group (10.2% vs. 21.3%), corresponding to a 60% relative risk reduction. In multivariable analysis, FloTrac\u00ae monitoring (OR 0.37, 95% CI 0.18\u20130.78,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.008), female sex (OR 3.78, 95% CI 1.83\u20137.81,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u20090.001) and higher body weight (OR 1.04, 95% CI 1.00\u20131.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u20090.034) emerged as independent predictors. FloTrac\u00ae monitoring was further associated with reduced intraoperative blood loss and lower colloid infusion volumes. All other peri\u2010operative and postoperative variables, including complication rates (Clavien\u2010Dindo \u2265 3), did not differ significantly between FloTrac\u00ae and control group (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0\u2265\u00a00.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FloTrac\u00ae monitoring was independently associated with a markedly lower risk of postoperative paralytic ileus after radical cystectomy. Female sex and higher body weight were identified as additional risk factors. Our findings underscore the potential of FloTrac\u00ae\u2010Monitoring to enhance postoperative gastrointestinal recovery for radical cystectomy. Nevertheless, overall surgical complication rates remained comparable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bco2.70232","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:44:51Z","timestamp":1787618691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reducing paralytic ileus after radical cystectomy: The role of advanced haemodynamic monitoring"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3993-7974","authenticated-orcid":false,"given":"Constantin","family":"Rieger","sequence":"first","affiliation":[{"name":"Department of Urology, Urologic Oncology, Robot\u2010Assisted and Specialized Urologic Surgery University of Cologne  Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Till","family":"L\u00f6hr","sequence":"additional","affiliation":[{"name":"Department of Urology, Urologic 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