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Updated: Jul 28, 2025

Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Complications After Radical Cystectomy: A Systematic Review and Meta-analysis of Randomized Controlled Trials with a
Stamatios Katsimperis1, Lazaros Tzelves2, Zafer Tandogdu2
1Second Department of Urology, Sismanoglio Hospital, Athens, Greece.
Context:
Radical cystectomy is considered a procedure of high complexity with a relative high complication rate.
Objective:
To systematically summarize the literature regarding the complications of radical cystectomy and the factors that contribute to them.
Evidence Acquisition:
We searched MEDLINE/PubMed, ClinicalTrials.gov, and Cochrane Library, according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for randomized controlled trials (RCTs) on complications related to radical cystectomy.
Evidence Synthesis:
A total of 3766 studies were screened, and 44 studies were included in this systematic review and meta-analysis. Complications following radical cystectomy are quite common. The most common complications were gastrointestinal complications (20%), infectious complications (17%), and ileus (14%). The majority of complications occurring were Clavien I-II (45%). Specific measurable patient factors are related to certain complications and can be used to stratify risk and assist in preoperative counseling, while proper design of high-quality RCTs may better reflect real-life complication rates.
Conclusions:
In our study, RCTs with a low risk of bias had higher complication rates than studies with a high risk of bias, underlining the need for further improvement on complication reporting in order to refine surgical outcomes.
Patient Summary:
Radical cystectomy is usually followed by high complication rates, which affect patients and are, in turn, strongly associated with patients' preoperative health status.
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