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Not just about weight: Identifying hidden nutritional vulnerability after radical cystectomy
Jakob Højgaard Hundebøll1, Alberte Fisker Olesen2, Irene Wessel2,3,4
1Clinical Nutrition Center, Department of Transplantation and Digestive Diseases, Rigshospitalet, Copenhagen, Denmark. jakob.hundeboell@regionh.dk.
European Journal of Clinical Nutrition
|December 10, 2025
Summary
Radical cystectomy patients experience poor nutrition post-surgery. Early weight changes don
Area of Science:
- Urology
- Surgical Nutrition
- Postoperative Care
Background:
- Radical cystectomy (RC) patients face significant nutritional challenges.
- Nutritional intake and adequacy post-RC are not well-defined.
- Enhanced Recovery After Surgery (ERAS) protocols are used.
Purpose of the Study:
- To prospectively evaluate dietary intake patterns and nutritional status in ERAS-managed RC patients.
- To identify factors influencing nutritional deterioration post-radical cystectomy.
Main Methods:
- Prospective observational study of 25 patients undergoing radical cystectomy managed with ERAS.
- Assessment of energy and protein intake, body weight, and nutritional symptoms.
- Comparison of weight loss between patients with and without nasogastric decompression.
Main Results:
- Low energy and protein adequacy observed in the first postoperative week.
- Stable body weight initially, followed by significant weight loss by day 14 (-2.3%) and day 30 (-5.3%).
- Patients requiring nasogastric decompression showed greater weight loss (-7.2%) compared to those without (-3.9%).
Conclusions:
- Early weight trajectory alone is an insufficient indicator of nutritional status post-RC.
- Comprehensive assessment including dietary intake, symptoms, and fluid balance is crucial.
- Individualized, symptom-responsive strategies, potentially including supplemental nutrition, are important for managing nutritional challenges.
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