Quality-of-Life Outcomes in Female Patients With Ileal Conduit or Orthotopic Neobladder Urinary Diversion: 6-Month Results of a Multicenter Prospective Study

Siracusano, Salvatore; Zaka, Agustina; Bassi, Pierfrancesco; Gontero, P.; Mearini, Ettore; Imbimbo, Ciro; Simonato, A.; Moro, Fabrizio Dal; Giannarini, Gianluca; Valotto, Claudio; Montorsi, F.; Colombo, Renzo; Porpiglia, Francesco; Bartoletti, Riccardo; Vella, Marco; Minervini, Andrea; Antonio, Benito Porcaro; Romantini, Federico; Vicentini, Carlo; Talamini, Renato; Ficarra, Vincenzo; Lonardi, Cristina

doi:10.3389/fonc.2022.855546

Cited by 6 publications

(8 citation statements)

References 19 publications

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“…Six of the cystectomy studies were dedicated to understanding sexual outcomes of surgery in female patients (see Table 3). Eight studies looked at oncological outcomes, quality of life and functional outcomes including sexual function with different types of urinary diversion/reconstruction 11,12,29–35 …”

Section: Resultsmentioning

confidence: 99%

“…13 A limited number of studies (n = 7) have examined sexual function in females having cystectomy often centred around a modified surgical approach. 11,12,[29][30][31][32]34,35,65 Outcomes on sexual function varied but generally reported a better outcome with a modified surgical approach. 11,31,33 However, it was also found that this diminished over time.…”

Section: Discussionmentioning

confidence: 99%

“…Current European Association of Urology (EAU) guidelines consider the removal of the sexual organs and anterior vaginal wall to be the standard of care 13 . A limited number of studies ( n = 7) have examined sexual function in females having cystectomy often centred around a modified surgical approach 11,12,29–32,34,35,65 . Outcomes on sexual function varied but generally reported a better outcome with a modified surgical approach 11,31,33 .…”

Section: Discussionmentioning

confidence: 99%

“…Eight studies looked at oncological outcomes, quality of life and functional outcomes including sexual function with different types of urinary diversion/reconstruction. 11,12,[29][30][31][32][33][34][35] It is reported that up to 70% of female patients with a BC diagnosis experienced a degree of sexual dysfunction. 36 This was enhanced in patients having cystectomy and urinary diversion of any type.…”

Section: Radical Cystectomymentioning

confidence: 99%

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Female sexual function in bladder cancer: A review of the evidence

et al. 2022

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Background Bladder cancer (BC) treatments are known to be invasive; nevertheless, research into the long‐term effects is limited and in the context of sexual function often male focussed. Female sexual dysfunction (FSD) has been reported in up to 75% of female patients. This systematic scoping review examines the literature on sexual consequences of BC in female patients. Objective This study aimed to systematically evaluate the evidence on female sexual function in BC to identify areas of unmet need and research priorities. Evidence Acquisition We performed a critical review of PubMed, PsychMed, CINAHL, MEDLINE and the Cochrane Library in March 2020 according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) extension for Scoping Reviews statement following Levac et al. methodology. Identified reports were reviewed according to the Critical Appraisal Skills Programme (CASP) criteria. 45 publications were included. Evidence Synthesis There was an inconsistent use of patient‐reported outcome measures (PROMs), with commonly used PROMs having a narrow symptom focus. However, common symptoms emerged: loss of desire, orgasmic disorders, vaginal dryness, dyspareunia, difficult intromission, reduced clitoral sensation, psychological concerns related to diagnosis, fear of contamination and body image. Sexual activity was reduced in most groups, despite women expressing a motivation to retain sexual function. The degree of symptom distress associated with FSD is underreported. Evidence emerged regarding a gap for women in clinician counselling and follow‐up. Conclusions The patient's perspective of FSD in BC patients is poorly understood and under‐addressed in clinical practice. There have been very few qualitative studies of FSD in BC. Any intervention designed to address the problem must start with greater understanding of both the patients' and clinicians' perspective. Lay Summary We examined the evidence on sexual consequences of BC in women. It is apparent that despite common themes of sexual dysfunction emerging, the problem is poorly understood and addressed in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Radical Cystectomymentioning

confidence: 99%

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Female sexual function in bladder cancer: A review of the evidence

et al. 2022

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“…7,9,10 Moreover, socioeconomic and cultural differences among nations may affect the UD of choice. 11,12 In spite of the abundant number of related studies in developed countries, there has been a striking scarcity of reports from developing countries and especially the Middle East region 13,14 ; urging further investigations. Consequently, the current study was designed and conducted to address this deficiency in the literature.…”

Section: Introductionmentioning

confidence: 99%

Comparison of different urinary diversions after radical cystectomy in Iran: Assessment of health-related quality of life and financial burden in a Middle Eastern country

Basiri,

Zahir,

Soleimani

et al. 2023

Urologia

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Objectives: To compare health-related quality of life (HRQOL), cost-effectiveness, and survival among different types of urinary diversion (UD) utilized after radical cystectomy (RC) for bladder cancer with consideration of the unique economic and cultural context in Iran. Patients and methods: In this retrospective study, we examined all patients who underwent RC from May 2017 to December 2021 at two specialized centers by the same surgical team. Patients were grouped based on their UD. Post-surgical HRQOL (obtained from EORTC QLQ-C30 and QLQBLM-30), financial burden, surgical complications, and survival were compared. Kruskal-Wallis H test, One-way ANOVA, and Kaplan-Meier analyses were utilized; accordingly. Results and limitations: In total 187 patients were identified—orthotopic neobladder (ONB) ( N = 75), ileal conduit (IC) ( N = 57), and cutaneous ureterostomy (CU) ( N = 55)—and were followed for a median 17.5 (Interquartile range: 7.0, 47.0) months. ONB was associated with better HRQOL, especially in the domains addressing physical, role and social functioning ( p = 0.003, 0.011, 0.045) as well as better body image ( p < 0.001), lower short- and long-term financial burden ( p = 0.034 and <0.001, respectively), marginally lower complication rate ( p = 0.049), and better 5-year overall survival ( p < 0.001), in comparison with other UDs. Patients who underwent CU had the lowest HRQOL and worst survival. Limitations were retrospective design and possibility of selection bias. Conclusions: In this first study that assesses a Middle Eastern collective; ONB seems to be the UD of choice with regard to HRQOL and economic burden when there is no contraindication.

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