Update of the ICUD–SIU International Consultation on Bladder Cancer 2018: urinary diversion
To provide a comprehensive overview and update of the joint consultation of the International Consultation on Urological Diseases (ICUD) and Société Internationale d’Urologie on Bladder Cancer Urinary Diversion (UD).
A detailed analysis of the literature was conducted reporting on the different modalities of UD. For this updated publication, an exhaustive search was conducted in PubMed for recent relevant papers published between October 2013 and August 2018. Via this search, a total of 438 references were identified and 52 of them were finally eligible for analysis. An international, multidisciplinary expert committee evaluated and graded the data according to the Oxford System of Evidence-based Medicine.
The incidence of early complications has been reported retrospectively in the range of 20–57%. Unfortunately, only a few randomized controlled studies exist within the field of UD. Consequently, almost all studies used in this report are of level 3–4 evidence including expert opinion based on “first principles” research.
Complications rates overall following RC and UD are significant, and when strict reporting criteria are incorporated, they are much higher than previously published. Complications can occur up to 20 years after surgery, emphasizing the need for lifelong follow-up. Progress has been made to prevent complications implementing robotic surgery and fast track protocols. Preoperative patient information, patient selection, surgical techniques, and careful postoperative follow-up are the cornerstones to achieve good results.
KeywordsUrinary diversion Radical cystectomy and complications MIBC and urinary diversions
Protocol/project development: ORF, MDT, JP, RH. Data collection or management: all authors. Data analysis: ORF, JP, RH. Manuscript writing/editing: all authors.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Research involving human participants and/or animals
For this type of study formal consent is not required. This article does not contain any studies with human participants or animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.
- 2.Philips B, Ball C, Sackett D et al (2009) Oxford centre for evidence-based medicine—levels of evidence (March 2009). http://www.cebm.net/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/
- 13.Cerruto MA, D’Elia C, Siracusano S et al (2016) 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 42:343–360CrossRefGoogle Scholar
- 20.Yong SM, Dublin N, Pickard R et al (2003) Urinary diversion and bladder reconstruction/replacement using intestinal segments for intractable incontinence or following cystectomy. Cochrane Database Syst Rev 2:CD003306Google Scholar
- 32.Gilja I, Kovacic M, Radej M et al (1996) The sigmoidorectal pouch (Mainz pouch II). Eur Urol 29:210–215Google Scholar