Ileal conduit versus neobladder: A propensity score‐matched analysis of the effect on renal function

Iqbal, Umar; Houenstein, Holly; Elsayed, Ahmed S.; Jing, Zhe; James, Gaybrielle; Hussein, Ahmed A.

doi:10.1111/iju.14747

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…Although some studies reported a negative impact of orthotopic neobladder on postoperative renal function [53], high-level evidence is available supporting the long-term safety of this type of diversion. Iqbal et al [54] reported similar postoperative GFR up to 5 years following RC with neobladder vs. ileal conduit. Moreover, in a large prospective randomized trial involving 484 patients undergoing RC with either a Studer or T-pouch orthotopic neobladder, the type of ileal orthotopic neobladder was not independently related to 3-year renal function [12].…”

Section: Renal Function Deteriorationmentioning

confidence: 87%

Comparative performance of the different orthotopic urinary diversions

Moghaddam

Ghoreifi

Djaladat

2022

Current Opinion in Urology

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Purpose of reviewMajority of patients undergoing radical cystectomy are suitable for orthotopic urinary diversion. The effect of different techniques of neobladder reconstruction on early and long-term postoperative complications is still being determined. Additionally, it is unclear which type of neobladder provides the best patient satisfaction. The purpose of this article is to review the outcomes of different orthotopic urinary diversions following radical cystectomy.Recent findingsIleal neobladder is the preferred type of orthotopic urinary diversion following radical cystectomy. Hautmann and Studer, which are the most common orthotopic diversion techniques, provide daytime continence rate up to 87% and 92%, respectively. However, nighttime continence is achieved in about 50% of patients. High-level evidence supports the long-term safety of orthotopic neobladder in terms of renal function, even in patients with a glomerular filtration rate <60 ml/min. Sexual dysfunction is the only independent factor associated with poorer quality of life in these patients.SummaryThe best type of neobladder is still uncertain. However, Studer and Hautmann are the most commonly performed techniques that provide favorable short- and long-term outcomes.

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Section: Renal Function Deteriorationmentioning

confidence: 87%

Comparative performance of the different orthotopic urinary diversions

Moghaddam

Ghoreifi

Djaladat

2022

Current Opinion in Urology

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Renal function outcome after selective bladder-preserving tetramodality therapy consisting of maximal transurethral resection, induction chemoradiotherapy and consolidative partial cystectomy in comparison with radical cystectomy for patients with muscle-invasive bladder cancer: a two-centre retrospective study

Fujiwara

Yokoyama

Toide

et al. 2022

Japanese Journal of Clinical Oncology

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Objective To compare renal function (RF) outcomes after bladder-preserving tetramodal therapy against muscle-invasive bladder cancer (MIBC) to those after radical cystectomy (RC). Methods This study included 95 patients treated with tetramodal therapy consisting of transurethral bladder tumour resection, chemoradiotherapy and partial cystectomy (PC) and 300 patients treated with RC. The annual change in the estimated glomerular filtration rate (eGFR) was compared using the linear mixed model. Renal impairment was defined as a >25% decrease from the pretreatment eGFR, and renal impairment-free survival (RIFS) was calculated. The association between treatment type and renal impairment was assessed. Results The number of patients who received neoadjuvant chemotherapy was 8 (8.4%) in the tetramodal therapy group and 75 (25.0%) in the RC group. After the inverse probability of treatment weighting adjustments, the baseline characteristics were balanced between the treatment groups. The mean eGFR before treatment in tetramodal therapy and RC groups was 69.4 and 69.6 mL/min/1.73 m2 and declined with a slope of −0.7 and −1.5 mL/min/1.73 m2/year, respectively. The annual deterioration rate of post-treatment eGFR in the tetramodal therapy group was milder than in the RC group. The 5-year RIFS rate in the tetramodal therapy and the RC groups was 91.2 and 85.2%, respectively. Tetramodal therapy was an independent factor of better RIFS compared with RC. Conclusions RF was better preserved after tetramodal therapy than after radical therapy; however, even after tetramodal therapy, the eGFR decreased, and a non-negligible proportion of patients developed renal impairment.

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Editorial Comment to Ileal conduit versus neobladder: A propensity score‐matched analysis of the effect on renal function

Takahara

Shiroki

2021

Int J of Urology

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Ileal conduit versus neobladder: A propensity score‐matched analysis of the effect on renal function

Cited by 3 publications

References 23 publications

Comparative performance of the different orthotopic urinary diversions

Comparative performance of the different orthotopic urinary diversions

Editorial Comment to Ileal conduit versus neobladder: A propensity score‐matched analysis of the effect on renal function

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