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QUALITY OF LIFE AFTER CYSTECTOMY AND URINARY DIVERSION: AN EVIDENCE BASED ANALYSIS

2005; Lippincott Williams & Wilkins; Volume: 174; Issue: 5 Linguagem: Inglês

10.1097/01.ju.0000176463.40530.05

1527-3792

Elmar W. Gerharz, Åsa Månsson, Sonja M. Hunt, Eila C. Skinner, Wiking Månsson,

Urological Disorders and Treatments

No AccessJournal of UrologyReview Articles1 Nov 2005QUALITY OF LIFE AFTER CYSTECTOMY AND URINARY DIVERSION: AN EVIDENCE BASED ANALYSIS ELMAR W. GERHARZ, ÅSA MÅNSSON, SONJA HUNT, EILA C. SKINNER, and WIKING MÅNSSON ELMAR W. GERHARZELMAR W. GERHARZ , ÅSA MÅNSSONÅSA MÅNSSON , SONJA HUNTSONJA HUNT , EILA C. SKINNEREILA C. SKINNER , and WIKING MÅNSSONWIKING MÅNSSON View All Author Informationhttps://doi.org/10.1097/01.ju.0000176463.40530.05AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We critically examined the evidence supporting the widely accepted notion that patients undergoing continent urinary tract reconstruction after cystectomy experience superior quality of life outcomes than patients receiving a conduit. Materials and Methods: Based on a comprehensive MEDLINE literature search we retrieved and evaluated all full-length articles published in the English, French, German, Italian and Spanish languages comparing conduit diversion with continent cutaneous diversion and/or orthotopic bladder substitution with respect to quality of life or similar concepts. All studies were rated according to the International Consultation on Urological Diseases modification of Oxford Center for Evidence-Based Medicine levels of evidence. Results: The literature on quality of life after radical cystectomy for bladder cancer was rather extensive but generally of questionable quality. The main problems were flaws in the patient materials and methodologies used. To our knowledge not a single randomized, controlled study exists in the field. Because only few articles achieved a level of evidence better than III, the International Consultation on Urological Diseases rating system does not allow further differentiation among studies. Most studies showed that overall quality of life after cystectomy remained good in most patients irrespective of urinary diversion type. Conclusions: Existing studies are unable to prove that continent reconstruction after radical cystectomy is superior to conduit diversion. This review emphasizes the importance of performing well designed studies in the future. References 1 : Quality of life with reconstruction. Sem Urol Oncol2001; 19: 56. Google Scholar 2 Abrams, P., Grant, A. and Khoury, S.: Evidence-based medicine. Overview of the main steps for developing and grading guideline recommendations. In: Incontinence. Edited by P. Abrams, L. Cardozo, S. Khoury and A. Wein. Presented at 3rd International Consultation on Incontinence 2004. 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Link, Google Scholar From the Department of Urology, Julius Maximilians University Medical School (EWG), Würzburg, Germany, Departments of Nursing (ÅM) and Urology (WM), University Hospital, Lund, Sweden, Department of Public Health Sciences, University of Edinburgh (SH), Edinburgh, Scotland, and Norris Comprehensive Cancer Center, University of Southern California (ECS), Los Angeles, California© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byHussein A, Ahmed Y, May P, Ali T, Ahmad B, Raheem S, Stone K, Hasasnah A, Rana O, Cole A, Wang D, Loud P and Guru K (2017) Natural History and Predictors of Parastomal Hernia after Robot-Assisted Radical Cystectomy and Ileal Conduit Urinary DiversionJournal of Urology, VOL. 199, NO. 3, (766-773), Online publication date: 1-Mar-2018.Abdelhalim A, Elshal A, Elsawy A, Helmy T, Orban H, Dawaba M and Hafez A (2015) Bricker Conduit for Pediatric Urinary Diversion—Should we Still Offer It?Journal of Urology, VOL. 194, NO. 5, (1414-1419), Online publication date: 1-Nov-2015.Ritch C, Cookson M, Chang S, Clark P, Resnick M, Penson D, Smith J, May A, Anderson C, You C, Lee H and Barocas D (2014) Impact of Complications and Hospital-Free Days on Health Related Quality of Life 1 Year after Radical CystectomyJournal of Urology, VOL. 192, NO. 5, (1360-1364), Online publication date: 1-Nov-2014.Liu N, Hackney J, Gellhaus P, Monn M, Masterson T, Bihrle R, Gardner T, House M and Koch M (2013) Incidence and Risk Factors of Parastomal Hernia in Patients Undergoing Radical Cystectomy and Ileal Conduit DiversionJournal of Urology, VOL. 191, NO. 5, (1313-1318), Online publication date: 1-May-2014.Eswara J, Efstathiou J, Heney N, Paly J, Kaufman D, McDougal W, McGovern F and Shipley W (2011) Complications and Long-Term Results of Salvage Cystectomy After Failed Bladder Sparing Therapy for Muscle Invasive Bladder CancerJournal of Urology, VOL. 187, NO. 2, (463-468), Online publication date: 1-Feb-2012.Cheng J, Lawrentschuk N, Gyomber D, Rogerson J and Bolton D (2010) Cystectomy in Patients With Spinal Cord Injury: Indications and Long-Term OutcomesJournal of Urology, VOL. 184, NO. 1, (92-98), Online publication date: 1-Jul-2010.Large M, Katz M, Shikanov S, Eggener S and Steinberg G (2009) Orthotopic Neobladder Versus Indiana Pouch in Women: A Comparison of Health Related Quality of Life OutcomesJournal of Urology, VOL. 183, NO. 1, (201-206), Online publication date: 1-Jan-2010.Kouba E, Sands M, Lentz A, Wallen E and Pruthi R (2007) Incidence and Risk Factors of Stomal Complications in Patients Undergoing Cystectomy With Ileal Conduit Urinary Diversion for Bladder CancerJournal of Urology, VOL. 178, NO. 3, (950-954), Online publication date: 1-Sep-2007. Volume 174Issue 5November 2005Page: 1729-1736 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsurinary diversionbladderevidence-based medicinequality of lifeileumMetricsAuthor Information ELMAR W. GERHARZ More articles by this author ÅSA MÅNSSON More articles by this author SONJA HUNT More articles by this author EILA C. SKINNER More articles by this author WIKING MÅNSSON More articles by this author Expand All Advertisement PDF downloadLoading ...