Abstract: Objective To explore the risk factors for early peristomal moisture-associated skin damage (PMASD) after robot-assisted radical cystectomy (RARC) and urostomy in the elderly patients with bladder cancer, and to optimize the nursing strategies. Methods A retrospective analysis was performed on 172 elderly patients with RARC admitted to Department of Urology, the First Affiliated Hospital of Nanjing Medical Universiy from January 2016 to August 2024. According to whether PMASD occurred after urostomy, the patients were divided into non-PMASD group (n=107) and PMASD group (n=65). The basic information, clinical data, and ostomy-related data of the two groups were compared. Multivariate logistic regression was used to analyze the independent influencing factors for the early PMASD after RARC and urostomy in the elderly patients with bladder cancer. Results The proportion of patients undergoing radiotherapy was significantly higher and the Barthel index and the proportions of patients with ostomy bag replacement interval ≥7 days and standardized ostomy care behavior were lower in PMASD group than those in non-PMASD group (P<0.05). Multivariate logistic regression showed that radiotherapy history (OR=5.982, 95%CI:2.161-16.560, P<0.001) was an independent risk factor for PMASD, while high Barthel index (OR=0.975, 95%CI:0.952-0.999, P=0.040), ostomy bag replacement interval ≥7 days (OR=0.356, 95%CI: 0.163-0.776, P=0.009), and standardized ostomy care behavior (OR=0.201, 95%CI: 0.096-0.422, P<0.001) were protective factors for PMASD. Conclusions Radiotherapy history, low self-care ability after surgery, high frequency of ostomy bag replacement, and nonstandard stoma care behavior are influencing factors for early PMASD in the elderly patients with bladder cancer after RARC.

Key words: aged, robot-assisted radical cystectomy, urostomy, peristomal moisture-associated skin damage