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• W2056164511 abstract "No AccessJournal of UrologyReview Articles1 Jul 2005IS ORTHOTOPIC BLADDER REPLACEMENT THE NEW GOLD STANDARD? EVIDENCE FROM A SYSTEMATIC REVIEW G. NABI, S.M. YONG, E. ONG, G. McPHERSON, A. GRANT, and J. N’DOW G. NABIG. NABI More articles by this author , S.M. YONGS.M. YONG More articles by this author , E. ONGE. ONG More articles by this author , G. McPHERSONG. McPHERSON More articles by this author , A. GRANTA. GRANT More articles by this author , and J. N’DOWJ. N’DOW More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000162021.24730.4fAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In this systematic review we determined whether the outcome of orthotopic bladder replacement is superior to that of continent and incontinent urinary diversion. Materials and Methods: We searched MEDLINE, PubMed, EMBASE, CINAHL and the Cochrane Library from January 1990 to January 2003. A total of 3,370 abstracts were reviewed, including all types of studies from prospective, randomized, controlled studies to small, retrospective series. All relevant articles with at least 10 patients and a mean followup of at least 1 year were retrieved. There were no language restrictions. NonEnglish articles were translated. Comparisons were made between the major surgery types, including ileal conduit, continent diversion, bladder reconstruction and bladder replacement. All studies were scored using a predetermined quality assessment checklist to assess internal validity (bias and confounding) and external validity. Results: A total of 405 studies met inclusion criteria. There were 32 prospective and 373 retrospective studies describing a total of 32,795 patients. The majority of studies were incompletely or poorly described and outcomes were often not defined. When they were defined, definitions varied. In clinical outcomes ileal conduit diversions had the lowest operative complications rate but highest reported postoperative morbidity. They also had a higher reported incidence of symptomatic urinary tract infections. The rates of postoperative morbidity, mortality and need for reoperation varied widely among studies even for the same procedure. Of physiological outcomes metabolic acidosis was the most commonly reported metabolic complication in patients with various urinary diversions. The quality of the reported literature was poor. There were no studies of the health economic implications of performing 1 type of surgery vs another type. Conclusions: While enthusiasts regard orthotopic bladder replacement as the new gold standard when lower urinary tract function must be replaced, the level and quality of current evidence are poor. The immediate concern must be to rectify this paucity of evidence with well designed and well reported prospective studies, ideally in a randomized setting, comparing the various major forms of urinary diversion and bladder replacement surgery. References 1 : Life after cystectomy and orthotopic neobladder versus ileal conduit urinary diversion. Semin Urol Oncol2001; 19: 18. Google Scholar 2 : Orthotopic ileal neobladder. BJU Int2004; 93: 183. Google Scholar 3 : History of urinary diversion. Urol Int1998; 60: 1. Google Scholar 4 : Urinary diversion and bladder reconstruction/replacement using intestinal segments for intractable incontinence or following cystectomy. Cochrane Database Syst Rev2003; 1. CD003306. Google Scholar 5 : Comparison of Studer ileal neobladder and ileal conduit urinary diversion with respect to perioperative outcome and late complications. J Urol1998; 160: 721. 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Google Scholar From the Academic Urology Unit, Department of Surgery, School of Medicine and Health Services Research Unit (GM, AG), University of Aberdeen, Aberdeen, Scotland, United Kingdom© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byLowrance W, Rumohr J, Clark P, Chang S, Smith J and Cookson M (2018) Urinary Diversion Trends at a High Volume, Single American Tertiary Care CenterJournal of Urology, VOL. 182, NO. 5, (2369-2375), Online publication date: 1-Nov-2009.Somani B, Kumar V, Wong S, Pickard R, Ramsay C, Nabi G, Grant A and N’Dow J (2018) Bowel Dysfunction After Transposition of Intestinal Segments Into the Urinary Tract: 8-Year Prospective Cohort StudyJournal of Urology, VOL. 177, NO. 5, (1793-1798), Online publication date: 1-May-2007.GERHARZ E, MÅNSSON Å, HUNT S, SKINNER E and MÅNSSON W (2018) QUALITY OF LIFE AFTER CYSTECTOMY AND URINARY DIVERSION: AN EVIDENCE BASED ANALYSISJournal of Urology, VOL. 174, NO. 5, (1729-1736), Online publication date: 1-Nov-2005. Volume 174Issue 1July 2005Page: 21-28 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsoutcome assessment (health care)bladderurinary diversioncystectomyurologic surgical proceduresMetricsAuthor Information G. NABI More articles by this author S.M. YONG More articles by this author E. ONG More articles by this author G. McPHERSON More articles by this author A. GRANT More articles by this author J. N’DOW More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W2056164511 title "IS ORTHOTOPIC BLADDER REPLACEMENT THE NEW GOLD STANDARD? EVIDENCE FROM A SYSTEMATIC REVIEW" @default.
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