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Quality of life after cystectomy and urinary diversion: An evidence based analysis

Gerharz, EW; Månsson, Åsa LU ; Hunt, S; Skinner, EC and Månsson, Wiking LU (2005) In Journal of Urology 174(5). p.1729-1736
Abstract
Purpose: We critically examined the evidence supporting the widely accepted notion that patients undergoing continent urinary tract reconstruction after cystectomy experience superior quality of life outcomes than patients receiving a conduit. Materials and Methods: Based on a comprehensive MEDLINE literature search we retrieved and evaluated all full-length articles published in the English, French, German, Italian and Spanish languages comparing conduit diversion with continent cutaneous diversion and/or orthotopic bladder substitution with respect to quality of life or similar concepts. All studies were rated according to the International Consultation on Urological Diseases modification of Oxford Center for Evidence-Based Medicine... (More)
Purpose: We critically examined the evidence supporting the widely accepted notion that patients undergoing continent urinary tract reconstruction after cystectomy experience superior quality of life outcomes than patients receiving a conduit. Materials and Methods: Based on a comprehensive MEDLINE literature search we retrieved and evaluated all full-length articles published in the English, French, German, Italian and Spanish languages comparing conduit diversion with continent cutaneous diversion and/or orthotopic bladder substitution with respect to quality of life or similar concepts. All studies were rated according to the International Consultation on Urological Diseases modification of Oxford Center for Evidence-Based Medicine levels of evidence. Results: The literature on quality of life after radical cystectomy for bladder cancer was rather extensive but generally of questionable quality. The main problems were flaws in the patient materials and methodologies used. To our knowledge not a single randomized, controlled study exists in the field. Because only few articles achieved a level of evidence better than III, the International Consultation on Urological Diseases rating system does not allow further differentiation among studies. Most studies showed that overall quality of life after cystectomy remained good in most patients irrespective of urinary diversion type. Conclusions: Existing studies are unable to prove that continent reconstruction after radical cystectomy is superior to conduit diversion. This review emphasizes the importance of performing well designed studies in the future. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
evidence-based medicine, quality of life, urinary diversion, ileum, bladder
in
Journal of Urology
volume
174
issue
5
pages
1729 - 1736
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000232619700005
  • pmid:16217273
  • scopus:27544473745
ISSN
1527-3792
DOI
10.1097/01.ju.0000176463.40530.05
language
English
LU publication?
yes
id
14980bab-d180-4da5-ab2e-73d2851c008e (old id 218608)
date added to LUP
2007-08-23 08:38:08
date last changed
2017-10-22 04:30:52
@article{14980bab-d180-4da5-ab2e-73d2851c008e,
  abstract     = {Purpose: We critically examined the evidence supporting the widely accepted notion that patients undergoing continent urinary tract reconstruction after cystectomy experience superior quality of life outcomes than patients receiving a conduit. Materials and Methods: Based on a comprehensive MEDLINE literature search we retrieved and evaluated all full-length articles published in the English, French, German, Italian and Spanish languages comparing conduit diversion with continent cutaneous diversion and/or orthotopic bladder substitution with respect to quality of life or similar concepts. All studies were rated according to the International Consultation on Urological Diseases modification of Oxford Center for Evidence-Based Medicine levels of evidence. Results: The literature on quality of life after radical cystectomy for bladder cancer was rather extensive but generally of questionable quality. The main problems were flaws in the patient materials and methodologies used. To our knowledge not a single randomized, controlled study exists in the field. Because only few articles achieved a level of evidence better than III, the International Consultation on Urological Diseases rating system does not allow further differentiation among studies. Most studies showed that overall quality of life after cystectomy remained good in most patients irrespective of urinary diversion type. Conclusions: Existing studies are unable to prove that continent reconstruction after radical cystectomy is superior to conduit diversion. This review emphasizes the importance of performing well designed studies in the future.},
  author       = {Gerharz, EW and Månsson, Åsa and Hunt, S and Skinner, EC and Månsson, Wiking},
  issn         = {1527-3792},
  keyword      = {evidence-based medicine,quality of life,urinary diversion,ileum,bladder},
  language     = {eng},
  number       = {5},
  pages        = {1729--1736},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Journal of Urology},
  title        = {Quality of life after cystectomy and urinary diversion: An evidence based analysis},
  url          = {http://dx.doi.org/10.1097/01.ju.0000176463.40530.05},
  volume       = {174},
  year         = {2005},
}