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Functional Outcomes Following Radical Cystectomy in Women with Bladder Cancer: A Systematic Review.

Angela B Smith1, Karen Crowell2, Michael E Woods1

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Summary

Outcomes for women undergoing radical cystectomy for bladder cancer are poorly understood. This review highlights significant gaps in research regarding urinary, sexual, and bowel function, and quality of life in female patients.

Keywords:
CystectomyFunctional outcomesGender disparitiesOutcomes assessmentUrinary bladder neoplasms

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Area of Science:

  • Urology
  • Oncology
  • Women's Health

Background:

  • Outcomes for women undergoing radical cystectomy (RC) for bladder cancer (BCa) are understudied.
  • Many studies exclude female patients, leading to a lack of gender-specific data.

Purpose of the Study:

  • To characterize female-specific functional outcomes after RC and urinary diversion for BCa.
  • To review urinary, sexual, and bowel function, and quality of life in women treated for BCa.

Main Methods:

  • A systematic review of PubMed/Medline and Embase was conducted.
  • Forty-five publications were selected based on inclusion criteria, focusing on functional outcomes.
  • Studies were analyzed for urinary function, sexual function, bowel function, and quality of life.

Main Results:

  • Data on functional outcomes in women undergoing RC for BCa are limited and show high risk of bias.
  • Urinary incontinence rates were around 20% (day and night), with hypercontinence at 10-20%.
  • Sexual function outcomes were generally poor, with limited use of standardized assessment tools; HRQOL showed significant differences compared to the general population.

Conclusions:

  • Functional outcomes in women after RC for BCa are poorly documented.
  • Limitations include small sample sizes, heterogeneous populations, and inconsistent use of validated questionnaires.
  • Further collaborative research is needed to better define these outcomes in female patients.