To analyze the functional and sports performance evolution one year after of a patient with an ONR due to oncological causes.
A 55-year-old male patient diagnosed with neuroendocrine bladder cancer who underwent radical cystectomy with ONR (Studder technique) after neoadjuvant CMT. He is an experienced amateur athlete (cyclist), physiotherapist and university academic, so he was self-therapist in the pre and post-surgical stages, with the advice of a specialist physioterapists. With the authorization and supervision of the treating oncologist, he continued sport training from the start of CMT until three days prior to surgery (16 weeks). Three months after surgery, he was authorized to gradually resume cycling. Recorded his functional progress in a logbook, while his cycling training was recorded in the Strava App. He trained on safe, paved circuits, individually, in a “time trial” mode. Strava app was used to identify and select seven segments, those with the greatest distance and the highest number of repetitions, and the average speed (km/hr) of each was collected. Records in which there were stops were discarded. The data were grouped in three stages. 1° Pre-diagnosis (1 year prior) 2° CMT stage (16 weeks) and 3° Post surgery (1 year, divided in three sub stages). The average speed of the seven segments in each stage was calculated and compared each other.
He returned to his academic work after 42 days. Six months after surgery, voluntary daytime continence increased from 2 to 4 hours; although at this time, he must use a night protector and stop sleeping at 3h 30 min to void the bladder. Regarding cycling, the average speed calculated in stage 1 was 30.36, which decreased to 27.9 in CMT stage. In sub stages 3.1, 3.2 and 3.3 was, respectively, 28.13, 29.03 and 29.73, which is equivalent to 91.65%, 95.62% and 97.92% of the performance prior to diagnosis. The position on the road bicycle did not cause discomfort, episodes of incontinence, or subsequent adverse effects, and has never reported urinary retention.
The ONR represented not only a functional and work recovery, but also allowed the return to road cycling training, gradually recovering his pre -diagnosis capacity.
This case report could be the first ever to present evidence that gives hope to sports patients with ONR, even for oncological reasons, regarding being able to return to high-demand sports, and could open a new perspective in a field of pelvic floor physiotherapy.
Orthotopic Neobladder Reconstruction
Pelvic Floor Physiotherapy
