{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T16:29:34Z","timestamp":1774110574176,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>A comprehensive scoring system for standardizing quality of functional outcomes of orthotopic ileal neobladders (OINs) is still unavailable. In this study we propose a novel trifecta for both open and robot\u2010assisted radical cystectomy conceived on urodynamic parameters that summarize OINs functional outcomes regardless of the surgical technique used and predicts continence status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials &amp; Methods<\/jats:title><jats:p>Between June 2017 and May 2023 two prospective, institutional review board approved, radical cystectomy datasets were matched and queried for \u201cOINs\u201d \u201cand \u201curodynamic evaluation\u201d (<jats:italic>n<\/jats:italic>\u2009=\u2009149). Urodynamic assessment was performed between 6 and 9 months after surgery. Baseline data and complete urodynamic profile including uroflowmetry, cystometry, compliance, presence of residual peristaltic activity, abdominal leak point pressures (ALPP) and daytime and night\u2010time continence were reported. Descriptive analyses were used. Frequencies and proportions were reported for categorical variables while medians and interquartile ranges (IQRs) were reported for continuously coded variables. Trifecta was defined as the coexistence of: cystometric capacity \u2265\u2009250 cc; neobladder compliance \u2265\u200935 cmH<jats:sub>2<\/jats:sub>0; negative Valsalva and abdominal leak point pressure testing. Simultaneous achievement of only two of the presented criteria was considered a suboptimal result. Logistic regression analyses were built to identify predictors of daytime and night\u2010time urinary continence. For all analyses, a two\u2010sided <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 was considered significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, at a median follow\u2010up of 25 months (IQR 16\u201337), 149 patients achieved a complete urodynamic evaluation. In the current series, the complete trifecta rate was 40.2% while a suboptimal trifecta achievement was observed in 35.6% of patients. On multivariable analysis, complete trifecta achievement was the only independent predictor of daytime (OR 7.29, 95% CI 2.05\u201325.9) and night\u2010time (OR 8.13; 95% CI 2.94\u201322.4) urinary continence, respectively (each <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.003). A complete UDM\u2010T at urodynamic testing was associated with a day\u2010time continence, night\u2010time continence, and complete dry status rates of 93.2%, 83.1%, and 79.7%, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This novel urodynamic trifecta for OINs is based on standardized parameters and seems to be predictor of either daytime or night\u2010time urinary continence at a midterm follow\u2010up. Satisfactory continence outcomes may be also expected when a suboptimal trifecta rate is achieved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p>Not applicable.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.70078","type":"journal-article","created":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T05:49:36Z","timestamp":1747633776000},"page":"1255-1263","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A Novel Scoring System to Assess Continence Quality Outcomes of Orthotopic Ileal Neobladders After Open and Robot\u2010Assisted Radical Cystectomy: The Urodynamic Trifecta"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7586-4132","authenticated-orcid":false,"given":"Umberto","family":"Anceschi","sequence":"first","affiliation":[{"name":"Department of Urologic Oncology IRCCS \u201cRegina Elena\u201d National Cancer Institute (NCI) Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1885-4808","authenticated-orcid":false,"given":"Fabrizio","family":"Di Maida","sequence":"additional","affiliation":[{"name":"Department of Urology \u201cAOU Careggi\u201d \u2013 University of Florence Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8821-8201","authenticated-orcid":false,"given":"Giuseppe","family":"Chiacchio","sequence":"additional","affiliation":[{"name":"Department of Urologic Oncology IRCCS \u201cRegina Elena\u201d National Cancer Institute (NCI) Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3708-2209","authenticated-orcid":false,"given":"Riccardo","family":"Mastroianni","sequence":"additional","affiliation":[{"name":"Department of Urologic Oncology IRCCS \u201cRegina Elena\u201d National Cancer Institute (NCI) Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4480-9090","authenticated-orcid":false,"given":"Gabriele","family":"Tuderti","sequence":"additional","affiliation":[{"name":"Department of Urologic Oncology IRCCS \u201cRegina Elena\u201d National Cancer Institute (NCI) Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3326-219X","authenticated-orcid":false,"given":"Luca","family":"Lambertini","sequence":"additional","affiliation":[{"name":"Department of Urology \u201cAOU Careggi\u201d \u2013 University of Florence Florence Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5529-3064","authenticated-orcid":false,"given":"Simone","family":"Albisinni","sequence":"additional","affiliation":[{"name":"Department of Urology \u201cPoliclinico Tor Vergata Rome Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Mattioli","sequence":"additional","affiliation":[{"name":"Department of Urology \u201cPoliclinico S. 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