Updated Assessment of Neobladder Utilization and Morbidity According to Urinary Diversion After Radical Cystectomy: A Contemporary US-population-based Cohort

Overview

Journal Can Urol Assoc J

Specialty Urology

Date 2013 Sep 27

PMID 24069095

Citations 12

Authors

Florian Roghmann

Andreas Becker

Quoc-Dien Trinh

Orchidee Djahangirian

Orchidee Djahagirian

Zhe Tian

Malek Meskawi

Shahrokh F Shariat

Markus Graefen

Pierre Karakiewicz

Joachim Noldus

Maxine Sun

Affiliations

Soon will be listed here.

Abstract

Background: In this paper, we examine contemporary utilization rates and determinants of neobladder (NB) after radical cystectomy (RC) relative to ileal conduit (IC), as well as provide an updated assessment of postoperative morbidity and mortality between NB and IC.

Methods: Relying on the Nationwide Inpatient Sample (NIS), we abstracted patients who underwent RC between 2000 and 2010. Subsequently, NB and IC recipients were identified. Use of NB was assessed after accounting for case-mix. Propensity-based matched analyses were used to account for treatment selection biases. Generalized linear regression analyses focused on intra- and postoperative complications, prolonged length of stay, blood transfusions and in-hospital mortality.

Results: The utilization rate of NB was 6.9% in 2000 and 9.1% in 2010 (p < 0.001). Younger, healthier, privately-insured and wealthier male individuals were more likely to receive a NB. High-volume hospitals were more likely to offer NB. In the post-propensity matched cohort, urinary diversion type failed to be significantly associated with the examined endpoints, except for intra- and postoperative complications (IC vs. NB odds ratio [OR]: 1.15, p = 0.04).

Interpretation: Despite comparable morbidity and mortality odds between NB and IC, as of the most contemporary year of the study (2010), IC remains the preferred urinary diversion type. Several sociodemographic factors were associated with NB.

Citing Articles

Urinary Diversion Versus Adverse In-Hospital Outcomes After Radical Cystectomy.

Penaranda N, Di Bello F, Marmiroli A, Falkenbach F, Longoni M, Le Q Ann Surg Oncol. 2024; 32(3):2233-2240.

PMID: 39656392 DOI: 10.1245/s10434-024-16644-4.

Comparison of postoperative complications of ileal conduits versus orthotopic neobladders.

Demaegd L, Albersen M, Muilwijk T, Milenkovic U, Moris L, Everaerts W Transl Androl Urol. 2021; 9(6):2541-2554.

PMID: 33457228 PMC: 7807350. DOI: 10.21037/tau-20-713.

Comparative analysis of the clinical effect and safety of Laparoscopic Radical Cystectomy + Orthotopic Ileal Neobladder and Open Surgery.

Liu Y, Dai H, Liu C, Zheng J Pak J Med Sci. 2021; 37(1):59-64.

PMID: 33437251 PMC: 7794141. DOI: 10.12669/pjms.37.1.2273.

A systematic review and meta-analysis of the long-term outcomes of ileal conduit and orthotopic neobladder urinary diversion.

Browne E, Lawrentschuk N, Jack G, Davis N Can Urol Assoc J. 2020; 15(1):E48-E57.

PMID: 32701445 PMC: 7769520. DOI: 10.5489/cuaj.6466.

Patient decision aids for urinary diversion after radical cystectomy: their potential and pitfalls.

Browne E, Whooley J, Wang J, Davis N Transl Androl Urol. 2020; 8(Suppl 5):S507-S509.

PMID: 32042633 PMC: 6989859. DOI: 10.21037/tau.2019.08.17.

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