Outcome comparison between ileal conduit and orthotopic neobladder : an extended literature review

Abstract

Introduction: Bladder cancer is the 10th most common malignancy worldwide and represents a burden on both patients and healthcare providers. The management strategy for muscle-invasive bladder cancer is radical cystectomy with urinary diversion. Ileal conduit has been regarded as the main method of urinary diversion for several years. Orthotopic neobladder has been its main competitor since the development of newer techniques. --

Aim: The aim of this extended literature review to evaluate the evidence and outline arguments in favour or against ileal conduit and orthotopic neobladder with a special focus on morbidity, mortality, sexual dysfunction, tumour recurrence, renal function and quality of life. --

Methodology: A total of 17 relevant studies were identified – 15 cohort studies and 2 systematic reviews. These were appraised to establish rigour, reliability and validity. --

Results: Evidence from contemporary literature demonstrates that ileal conduit and orthotopic neobladder offer comparable outcomes when it comes to morbidity, mortality, relapse rates and acute or chronic kidney disease. However, neobladder could be the better option in consideration for the patient’s sexual function and quality of life. --

Conclusion: These findings were used to develop graded recommendations which could be applied to local clinical practice.