Complications and quality of life following urinary diversion after cystectomy

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Complications and quality of life following urinary diversion after cystectomy. / Gerharz, E W; Roosen, A; Månsson, Wiking.

In: EAU Update Series, Vol. 3, No. 3, 2005, p. 156-168.

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TY - JOUR

T1 - Complications and quality of life following urinary diversion after cystectomy

AU - Gerharz, E W

AU - Roosen, A

AU - Månsson, Wiking

PY - 2005

Y1 - 2005

N2 - bjective: The aim of this review is to outline specific surgical complications, metabolic consequences and quality of life (QOL) following urinary diversion in patients undergoing radical cystectomy. Methods: Based on a comprehensive literature search (MEDLINE) the published knowledge on urinary diversion was examined regarding the research question with an emphasis on contemporary cystectomy series. Results: Despite the fact, that urinary diversion is commonplace in these days and the existing literature is rather extensive, the vast majority of assumptions are based on low level evidence (retrospective, single-institutional case series with small sample sizes and short-term followup). There are few randomized trials in this field. Early and late surgical complications following radical cystectomy have decreased over the past three decades for both incontinent and continent diversion, but are still significant. While metabolic disturbances are common after continent forms of urinary diversion, the problems can be minimized in most cases. Most reports testify that QOL is high after cystectomy irrespective of type of urinary diversion although urinary and sexual problems are common. Conclusion: Careful patient selection, strict adherence to proper surgical technique and appropriate life-long follow-up are of paramount importance in the successful management of patients undergoing radical cystectomy for bladder cancer.

AB - bjective: The aim of this review is to outline specific surgical complications, metabolic consequences and quality of life (QOL) following urinary diversion in patients undergoing radical cystectomy. Methods: Based on a comprehensive literature search (MEDLINE) the published knowledge on urinary diversion was examined regarding the research question with an emphasis on contemporary cystectomy series. Results: Despite the fact, that urinary diversion is commonplace in these days and the existing literature is rather extensive, the vast majority of assumptions are based on low level evidence (retrospective, single-institutional case series with small sample sizes and short-term followup). There are few randomized trials in this field. Early and late surgical complications following radical cystectomy have decreased over the past three decades for both incontinent and continent diversion, but are still significant. While metabolic disturbances are common after continent forms of urinary diversion, the problems can be minimized in most cases. Most reports testify that QOL is high after cystectomy irrespective of type of urinary diversion although urinary and sexual problems are common. Conclusion: Careful patient selection, strict adherence to proper surgical technique and appropriate life-long follow-up are of paramount importance in the successful management of patients undergoing radical cystectomy for bladder cancer.

KW - Radical cystectomy

KW - Urinary diversion

KW - Urinary reservoirs

KW - continent

KW - Complications

KW - Metabolic consequences

KW - Quality of life

U2 - 10.1016/j.euus.2005.07.002

DO - 10.1016/j.euus.2005.07.002

M3 - Article

VL - 3

SP - 156

EP - 168

JO - EAU Update Series

T2 - EAU Update Series

JF - EAU Update Series

SN - 1570-9124

IS - 3

ER -