Long-Term Complications and Quality of Life After Urinary Diversion for Bladder Cancer: A Systematic Review and...

Urinary diversion after radical cystectomy (RC) for bladder cancer significantly influences long-term outcomes and patient quality of life. This systematic review and meta-analysis examined complications occurring five years or more post-RC across the three main diversion types: ileal conduit (IC), orthotopic neobladder (ONB), and continent cutaneous urinary diversion (CCUD). A total of 16 studies with 8,493 patients were included. We compared morbidity, mortality, reoperation, and urinary tract infection, along with patient-reported quality of life (QoL). The meta-analysis revealed that IC was associated with reduced urinary stone formation and improved global health scores, while better urinary function and body image perception were associated with ONB. Data on CCUD were limited, preventing meta-analysis, but qualitative findings suggested distinct functional and QoL benefits compared to IC and ONB. This study highlights the importance of individualized surgical decision-making based on long-term outcomes and patient preferences; however, the limited data on CCUD highlights the need for further high-quality research to clarify its long-term safety, functional outcomes, and QoL implications.