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Comparative performance of the different orthotopic urinary diversions
Farshad Sheybaee Moghaddam1, Alireza Ghoreifi, Hooman Djaladat
1Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Current Opinion in Urology
|July 18, 2022
Summary
Orthotopic urinary diversion using neobladder reconstruction after radical cystectomy offers good daytime continence. While nighttime continence varies, techniques like Studer and Hautmann demonstrate long-term safety and favorable outcomes.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Radical cystectomy is a common treatment for bladder cancer.
- Orthotopic urinary diversion is a viable option for many patients.
- Neobladder reconstruction techniques vary, impacting outcomes.
Purpose of the Study:
- To review and compare outcomes of different orthotopic urinary diversions post-radical cystectomy.
- To evaluate early and long-term postoperative complications.
- To assess patient satisfaction with various neobladder types.
Main Methods:
- Literature review of studies on orthotopic urinary diversions.
- Comparison of complication rates and continence outcomes.
- Analysis of patient satisfaction and quality of life data.
Main Results:
- Ileal neobladder is the preferred method.
- Studer and Hautmann techniques show high daytime continence rates (92% and 87%).
- Nighttime continence is achieved in approximately 50% of patients.
- Orthotopic neobladder is safe for renal function, even with reduced GFR.
- Sexual dysfunction negatively impacts quality of life.
Conclusions:
- The optimal neobladder technique is still debated.
- Studer and Hautmann techniques offer favorable short- and long-term results.
- Further research is needed to optimize patient satisfaction and nighttime continence.
