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Incidence and risk factors for postoperative vaginal events following radical cystectomy for bladder cancer : a nationwide population-based study

Kalén, Elin ; Ginstman, Charlotte ; Liedberg, Fredrik LU ; Hagberg, Oskar LU ; Holmbom, Martin ; Jerlström, Tomas ; Jahnson, Staffan ; Gårdmark, Truls ; Ströck, Viveka and Holmberg, Lars , et al. (2025) In BJU International 136(6). p.1128-1136
Abstract

Objective: To estimate the probability of vaginal events (diagnosis and/or surgery) following radical cystectomy (RC) and explore possible risk factors in a nationwide population-based observational registry based study. Patients and Methods: Women undergoing RC for urinary bladder cancer in Sweden, from 1 January 1997 to 31 December 2019, were identified within national registries. Women with any postoperative vaginal event (PVE), either a diagnosis or surgical repair related to a vaginal complication, were identified using diagnostic and treatment codes. The probability of developing a PVE was estimated based on the cumulative incidence proportion using a competing risk model. Additionally, a multivariable Cox proportional hazards... (More)

Objective: To estimate the probability of vaginal events (diagnosis and/or surgery) following radical cystectomy (RC) and explore possible risk factors in a nationwide population-based observational registry based study. Patients and Methods: Women undergoing RC for urinary bladder cancer in Sweden, from 1 January 1997 to 31 December 2019, were identified within national registries. Women with any postoperative vaginal event (PVE), either a diagnosis or surgical repair related to a vaginal complication, were identified using diagnostic and treatment codes. The probability of developing a PVE was estimated based on the cumulative incidence proportion using a competing risk model. Additionally, a multivariable Cox proportional hazards model was used to explore the risk factors for PVEs. Subgroup analysis was performed in patients operated from 2011 to 2019, where additional perioperative variables were registered. Results: The study encompassed 1914 women with a median age of 69 years at the time of bladder cancer diagnosis. The 5-year cumulative risk of PVEs in the entire cohort was 11% (95% confidence interval [CI] 9.5–12.5%). Subgroup analysis showed that robot-assisted RC and a body mass index (BMI) >30 kg/m2 were more often associated with PVEs after RC (hazard ratio [HR] 2.82, 95% CI 1.81–4.40; and HR 1.71, 95% CI 1.05–2.79, respectively). Conclusions: A clinically relevant cumulative incidence of PVEs following RC was identified. An association between robot-assisted RC or high BMI with increased risk of a PVE indicate the need for further studies on risk assessment of vaginal complications.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
bladder cancer, cumulative incidence, radical cystectomy, risk factor, vaginal events
in
BJU International
volume
136
issue
6
pages
9 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:105016590227
  • pmid:40974208
ISSN
1464-4096
DOI
10.1111/bju.70004
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 The Author(s). BJU International published by John Wiley & Sons Ltd on behalf of BJU International.
id
4939089d-ef45-49ee-9efd-c57317ee2ea6
date added to LUP
2025-12-09 15:18:55
date last changed
2025-12-10 03:00:02
@article{4939089d-ef45-49ee-9efd-c57317ee2ea6,
  abstract     = {{<p>Objective: To estimate the probability of vaginal events (diagnosis and/or surgery) following radical cystectomy (RC) and explore possible risk factors in a nationwide population-based observational registry based study. Patients and Methods: Women undergoing RC for urinary bladder cancer in Sweden, from 1 January 1997 to 31 December 2019, were identified within national registries. Women with any postoperative vaginal event (PVE), either a diagnosis or surgical repair related to a vaginal complication, were identified using diagnostic and treatment codes. The probability of developing a PVE was estimated based on the cumulative incidence proportion using a competing risk model. Additionally, a multivariable Cox proportional hazards model was used to explore the risk factors for PVEs. Subgroup analysis was performed in patients operated from 2011 to 2019, where additional perioperative variables were registered. Results: The study encompassed 1914 women with a median age of 69 years at the time of bladder cancer diagnosis. The 5-year cumulative risk of PVEs in the entire cohort was 11% (95% confidence interval [CI] 9.5–12.5%). Subgroup analysis showed that robot-assisted RC and a body mass index (BMI) &gt;30 kg/m<sup>2</sup> were more often associated with PVEs after RC (hazard ratio [HR] 2.82, 95% CI 1.81–4.40; and HR 1.71, 95% CI 1.05–2.79, respectively). Conclusions: A clinically relevant cumulative incidence of PVEs following RC was identified. An association between robot-assisted RC or high BMI with increased risk of a PVE indicate the need for further studies on risk assessment of vaginal complications.</p>}},
  author       = {{Kalén, Elin and Ginstman, Charlotte and Liedberg, Fredrik and Hagberg, Oskar and Holmbom, Martin and Jerlström, Tomas and Jahnson, Staffan and Gårdmark, Truls and Ströck, Viveka and Holmberg, Lars and Häggström, Christel and Aljabery, Firas}},
  issn         = {{1464-4096}},
  keywords     = {{bladder cancer; cumulative incidence; radical cystectomy; risk factor; vaginal events}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{1128--1136}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{BJU International}},
  title        = {{Incidence and risk factors for postoperative vaginal events following radical cystectomy for bladder cancer : a nationwide population-based study}},
  url          = {{http://dx.doi.org/10.1111/bju.70004}},
  doi          = {{10.1111/bju.70004}},
  volume       = {{136}},
  year         = {{2025}},
}