HRQOL related to urinary diversion in Radical Cystectomy: a systematic review of recent literature

• Published in: International Brazilian Journal of Urology Vol. 45; no. 6; pp. 1094 - 1104
• Main Authors: Pazeto, Cristiano Linck, Baccaglini, Willy, Tourinho-Barbosa, Rafael Rocha, Glina, Sidney, Cathelineau, Xavier, Sanchez-Salas, Rafael
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Urologia 01-11-2019
• Subjects: Cystectomy; Cystectomy - methods; Cystectomy - psychology; Cystectomy - rehabilitation; Female; Humans; Male; Quality of Life - psychology; Review; Surveys and Questionnaires - standards; Systematic Review [Publication Type]; Time Factors; Treatment Outcome; Urinary Diversion; Urinary Diversion - methods; Urinary Diversion - psychology; Urinary Diversion - rehabilitation; Urinary Diversion; Cystectomy; Systematic Review [Publication Type]
• ISSN: 1677-5538; 1677-6119
• DOI: 10.1590/s1677-5538.ibju.2018.0858

The health-related QoL is a patient-centered evaluation covering several aspects. This evaluation seems to be particularly important in patients submitted to radical cystectomy (RC) and urinary diversion with ileal conduit (IC) or a neobladder (NB).
Review all recent data comparing QoL outcomes after radical cystectomy with NB and IC diversions.
A systematic search in PubMed/Medline, Embase, and Cochrane databases was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement in December 2018. All articles published from January 01, 2012 to December 31, 2018, were included. A study was considered relevant if it compared QoL outcomes using validated questionnaires (EORTC QLQ C30, FACT-G, FACT-BL, FACT-VCI, and BCI).
In 11 included studies, a total of 1389 participants were accounted (730 NB and 659 IC cases). The studies were conducted in 8 different countries, two were prospective, and none was randomized. There were two studies favoring results with a neobladder, 3 with incontinent diversion and 6 with no differences. The EORTC-QLQ-C30 was the most used instrument (5 studies) followed by FACT VCI and BCI (3 studies each). Given the heterogeneity of data and lack of prospective studies, a meta-analysis was not performed.
No superiority of one urinary diversion was characterized. It seems that the choice must be individualized with an extensive preoperative orientation of the patient and their relatives. That will probably infl uence how the patient accepts the new condition.