What is the Urinary Diversion of Choice after Cystectomy in 2020?


urinary diversion
ileal conduit


How to Cite

Kharbach Y, Khallouk A. What is the Urinary Diversion of Choice after Cystectomy in 2020?. Integr J Med Sci [Internet]. 2020 Dec. 24 [cited 2024 Jun. 15];8. Available from: https://mbmj.org/index.php/ijms/article/view/320


Urinary diversion is often indicated after radical cystectomy for bladder cancer. It can either be non-contingent or continent. Ileal conduit and orthotopic urinary diversions (neobladder) are by far the most commonly used diversions. The choice of the urinary diversion to be carried out is done on several levels in relation to the underlying disease, the state of the patient, and the surgeon's preference. It is inappropriate to make direct comparisons between enterocystoplasty and ileal conduit because of the differences in the choice of patients for each technique making a prospective randomized trial unlikely.
The choice of the technique must be made after clearly informing and explaining to the patient to enable him accept and adapt to his urinary diversion.



Neuzillet Y, Rouprêt M; les membres du sous-comité vessie du CCAFU. Quality of life of patients carrying an urinary diversion. Prog Urol. 2017;27(14):845-50. https://doi.org/10.1016/j.purol.2017.06.001

Maurice MJ, Kim SP, Abouassaly R. Socioeconomic status is associated with urinary diversion utilization after radical cystectomy for bladder cancer. Int Urol Nephrol. 2017;49(1):77-82. https://doi.org/10.1007/s11255-016-1422-9

Salvadalena G, Hendren S, McKenna L, Muldoon R, Netsch D, Paquette I, et al. WOCN Society and AUA Position statement on preoperative stoma site marking for patients undergoing urostomy surgery. J Wound Ostomy Continence Nurs. 2015;42(3):253-6. https://doi.org/10.1097/won.0000000000000119

Nahar B, Koru-Sengul T, Miao F, Prakash NS, Venkatramani V, Gauri A, et al. Comparison of readmission and short-term mortality rates between different types of urinary diversion in patients undergoing radical cystectomy. World J Urol. 2018;36(3):393-9. https://doi.org/10.1007/s00345-017-2140-3

Gore JL, Saigal CS, Hanley JM, Schonlau M, Litwin MS. Urologic diseases in america project variations in reconstruction after radical cystectomy. Cancer. 2006;107(4):729-37. https://doi.org/10.1002/cncr.22058

Hautmann RE, de Petriconi RC, Pfeiffer C, Volkmer BG. Radical cystectomy for urothelial carcinoma of the bladder without neoadjuvant or adjuvant therapy: long-term results in 1100 patients. Eur Urol. 2012;61(5):1039-47. https://doi.org/10.1016/j.eururo.2012.02.028

Rouprêt M, Neuzillet Y, Pignot G, Compérat E, Audenet F, Houédé N, et al. Recommandations françaises du Comité de Cancérologie de l’AFU —Actualisation 2018—2020: tumeurs de la vessie French ccAFU guidelines —Update 2018—2020: Bladder cancer. Prog Urol. 2018;28(12S):S46-S78. https://doi.org/10.1016/j.purol.2018.07.283

Luchey AM, Agarwal G, Espiritu PN, Lockhart JL, Pow-Sang JM, Spiess PE, et al. Patient and disease-specific factors and their influence on urinary reconstruction choice at a referral center. World J Urol. 2015;33(11):1763-8. https://doi.org/10.1007/s00345-015-1532-5

Tao H, Songwathana P, Isaramalai SA, Zhang Y. Personal awareness and behavioural choices on having a stoma: a qualitative metasynthesis. J Clin Nurs. 2014;23(9-10):1186-200. https://doi.org/10.1111/jocn.12309

Barnabe NC, Dell'acqua MC. Coping strategies of ostomized individuals. Rev Lat Am Enfermagem.2008;16(4):712-9. https://doi.org/10.1590/s0104-11692008000400010

Engebretson JC, Headley JA. Cultural diversity and care. In Holistic Nursing: A Handbook for Practice. (Dossey BM & Keegan L eds). Jones and Bartlett Publishers, Sudbury, MA; 2009.

Lee RK, Abol-Enein H, Artibani W, Bochner B, Dalbagni G, Daneshmand S, et al. Urinary diversion after radical cystectomy for bladder cancer: options, patient selection, and outcomes. BJU Int. 2014;113(1):11-23. https://doi.org/10.1111/bju.12121

Hautmann RE, Abol-Enein H, Lee CT, Mansson W, Mills RD, Penson DF. Urinary diversion: how experts divert. Urology. 2015;85(1):233-8. https://doi.org/10.1016/j.urology.2014.06.075

Skinner EC. Choosing the right urinary diversion: patient's choice or surgeon's inclination? Urol Oncol. 2011;29(5):473-5. https://doi.org/10.1016/j.urolonc.2010.09.002

Hautmann RE, Abol-Enein H, Davidsson T, Gudjonsson S, Hautmann SH, Holm HV, et al. ICUD-EAU International Consultation on Bladder Cancer 2012: Urinary diversion. Eur Urol. 2013;63(1):67-80. https://doi.org/10.1016/j.eururo.2012.08.050

Hautmann RE. Declining use of orthotopic reconstruction worldwide-what went wrong? J Urol. 2018;199(4):900-3. https://doi.org/10.1016/j.juro.2017.10.031

Kwan ML, Leo MC, Danforth KN, Weinmann S, Lee VS, Munneke JR, et al. Factors that influence selection of urinary diversion among bladder cancer patients in 3 community-based integrated health care systems. Urology. 2019;125:222-9. https://dx.doi.org/10.1016%2Fj.urology.2018.09.037

Goossens-Laan CA, Gooiker GA, van Gijn W, Post PN, Bosch JL, Kil PJ, et al. A systematic review and meta-analysis of the relationship between hospital/surgeon volume and outcome for radical cystectomy: an update for the ongoing debate. Eur Urol. 2011;59(5):775-83. https://doi.org/10.1016/j.eururo.2011.01.037

Colwell JC, Gray M. Does preoperative teaching and stoma site markingaffect surgical outcomes in patients undergoing ostomy surgery? J Wound Ostomy Continence Nurs. 2007;34(5):492-6. https://doi.org/10.1097/01.won.0000290726.08323.a6

Yang LS, Shan BL, Shan LL, Chin P, Murray S, Ahmadi N, et al. A systematic review and meta-analysis of quality of life outcomes after radical cystectomy for bladder cancer. Surg Oncol. 2016;25(3):281-97. https://doi.org/10.1016/j.suronc.2016.05.027

Porter MP, Penson DF. Health related quality of life after radical cystectomy and urinary diversion for bladder cancer: a systematic review and critical analysis of the literature. J Urol. 2005;173(4):1318-22. https://doi.org/10.1097/01.ju.0000149080.82697.65

Cerruto MA, D'Elia C, Siracusano S, Gedeshi X, Mariotto A, Iafrate M, et al. Systematic review and meta-analysis of non RCT's on health related quality of life after radical cystectomy using validated questionnaires: Better results with orthotopic neobladder versus ileal conduit. Eur J Surg Oncol. 2016;42(3):343-60. https://doi.org/10.1016/j.ejso.2015.10.001

Ziouziou I, Irani J, Wei JT, Karmouni T, El Khader K, Koutani A, et al. Ileal conduit vs orthotopic neobladder: Which one offers the best health-related quality of life in patientsundergoing radical cystectomy? A systematic review of literature and meta-analysis. Prog Urol. 2018;28(5):241-50. https://doi.org/10.1016/j.purol.2018.02.001

Witjes JA, Bruins M, Cathomas R, Compérat E, Cowan NC, Gakis G et al. EAU guidelines on muscle-invasive and metastatic bladder cancer. EAU Guidelines. Edn. presented at the EAU Annual Congress Barcelona 2019. EAU Guidelines Office, Arnhem, The Netherlands.

Chang SS, Boorjian SA, Chou R, Clark PE, Daneshmand S, KonetyBR. Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO Guideline. J Urol. 2016. J Urol 2016;196(4):1021-9. https://doi.org/10.1016/j.juro.2016.06.049

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