The mean ± standard deviation (SD) (median) interval between surgery and first evaluation was 7.4 ± 6.5 (5.5) months and that between

the two evaluations was 4.2 ± 2.1 (3.0) months. During first follow up, it was noticed that many patients were not able to do pelvic floor relaxation properly. The correct technique was re-emphasized and the participants encouraged to continue performing strengthening as well as relaxation as taught (Fig. 1). EX 527 research buy No significant difference was observed in overall or domain-specific PQOL during the follow up (all P = NS; Table 1). Nevertheless, with continued supervised pelvic floor rehabilitation treatment, hesitancy score in voiding function domain showed a favorable but non-significant trend (P = 0.058). Clinically significant day-time incontinence (more than a few drops) was present in three and two patients, and clinically significant night-time incontinence Panobinostat clinical trial 11 and eight, at first and second follow-up, respectively (all

P = NS; Table 2). Details of urodynamic parameters are described in Table 3; no significant difference was observed in any of the urodynamic parameters between first and second follow up. However, the number of patients with low MUCP (< 30cmH2O) halved during follow up (6 vs. 3; P = 0.05; Fisher's exact test). The patients did not experience the usual filling sensations consistently as described by the International Continence Society. Cystometry tracings of all patients showed involuntary phasic-rhythmic contractions (IC) in pouch. In three patients the IC was of high amplitude and in one it was associated with incontinence (Fig. 2). All patients voided with abdominal straining. The group-mean maximum rise in Pabd (ΔPabd.max) over baseline was 69.0 ± 40.4 cmH2O during the first study and 70.8 ± 33.1 cmH2O during the second

study. Qmax did not correlate with fall in ID-8 electromyography (EMG) during the first study; however, during the second study, fall in EMG did correlate with Qmax, though weakly (Fig. 3). Pouch-related QOL was found to be adversely affected by higher MCC (r = 0.828; P = 0.0001), smaller functional urethral length (r = −0.392; P = 0.023), higher body mass index (BMI) (r = 0.253; P = 0.033) and nocturnal incontinence (r = 0.429; P = 0.011). Nocturnal incontinence was associated with higher amplitude of rhythmic pouch contraction (P = 0.005) and lower FUL (P = 0.024) binominal logistic regression analysis. Filling and voiding pouchography did not reveal any reflux. No significant hydronephrosis was observed on ultrasonography. Orthotopic neobladder (ONB) are considered as one of the standards of care for patients requiring radical cystectomy. Most patients undergoing ONB replacement can achieve voluntary voiding and good urinary continence.[12-14] However, the mechanism of storage and evacuation is different from the physiological one.