Functional and oncological outcomes after radical cystectomy and orthotopic neobladder in women
Authors:
M. H. Zahran; B. Ali- el- dein
Published in:
Urol List 2014; 12(2): 45-51
Overview
The trend over the last two decades was toward the use of continent urinary diversion after radical cystectomy in women. The encouraging results of orthotopic neobladder (ONB) in men and the proved oncological and functional safety in early studies in women were behind the application of ONB in women. Many articles have been published in the last two decades concerning the outcome of ONB in women. In this mini‑review, the results of all the available literature concerning this issue and the impact of this surgery on the quality of life are discussed. The results showed lower incidence of local urethral recurrence in women than in men with the same operation. Day- and night- time continence in women was achieved in 57– 100% and 27– 92%, respectively. Chronic urinary retention and the use of clean intermittent catheterization were much higher in female patients. Sexual function was less affected in women after ONB than those with other forms of urinary diversion. Therefore, ONB should be the first option for females with bladder cancer as long as there is no absolute indication of concomitant urethrectomy.
Key words:
radical cystectomy, orthotopic diversion, results and complications, sexual function
Sources
1. Anderson CB, Cookson MS, Chang SS et al. Voiding function in women with orthotopic neobladder urinary diversion. J Urol 2012; 188(1): 200– 204. doi: 10.1016/ j.juro.2012.03.004.
2. Hassan JM, Cookson MS, Smith JA Jr et al. Urethral recurrence in patients following orthotopic urinary diversion. J Urol 2004; 172(4 Pt 1): 1338– 1341.
3. Colleselli K, Stenzl A, Eder R et al. The female urethral sphincter: a morphological and topographical study. J Urol 1998; 160(1): 49– 54.
4. Ghoneim MA. Orthotopic bladder substitution in women following cystectomy for bladder cancer. Urol Clin North Am 1997; 24(1): 225– 239.
5. Stenzl A, Colleselli K, Bartsch G. Update of urethra- sparing approaches in cystectomy in women. World J Urol 1997; 15(2): 134– 138.
6. Ali- El- Dein B, Shaaban AA, Abu- Eideh RH et al. Surgical complications following radical cystectomy and orthotopic neobladders in women. J Urol 2008; 180(1): 206– 210; discussion 210. doi: 10.1016/ j.juro.2008.03.080.
7. Hautmann RE. Which patients with transitional cell carcinoma of the bladder or prostatic urethra are candidates for an orthotopic neobladder? Curr Urol Rep 2000; 1(3): 173– 179.
8. Rosenblum N, Eliber KS, Rodriguez LV et al. Anatomy of pelvic support. In: Vasavada SP, Appel RA, Sand PK et al (eds). Female urology, urogynecology and voiding dysfunction. New York: Marcel Dekker 2005: 10– 12.
9. Strasser H, Ninkovic M, Hess M et al. Anatomic and functional studies of the male and female urethral sphincter. World J Urol 2000; 18(5): 324– 329.
10. Stein JP, Quek M, Skinner DG. Contemporary surgical techniques for continent urinary diversion: continence and potency preservation. Atlas Urol Clin North Am 2001; 9: 147– 152.
11. Ali- El-Dein B, Gomha M, Ghoneim MA. Critical evaluation of the problem of chronic urinary retention after orthotopic bladder substitution in women. J Urol 2002; 168(2): 587– 592.
12. Stein JP, Ginsberg DA, Skinner DG. Indications and technique of the orthotopic neobladder in women. Urol Clin North Am 2002; 29(3): 725– 734.
13. De Paepe ME, André R, Mahadevia P. Urethral involvement in female patients with bladder cancer. A study of 22 cystectomy specimens. Cancer 1990; 65(5): 1237– 1241.
14. Coloby PJ, Kakizoe T, Tobisu K et al. Urethral involvement in female bladder cancer patients: mapping of 47 consecutive cysto- urethrectomy specimens. J Urol 1994; 152(5 Pt 1): 1438– 1442.
15. Stein JP, Cote RJ, Freeman JA et al. Indications for lower urinary tract reconstruction in women after cystectomy for bladder cancer: a pathological review of female cystectomy specimens. J Urol 1995; 154(4): 1329– 1333.
16. Chen ME, Pisters LL, Malpica A et al. Risk of urethral, vaginal and cervical involvement in patients undergoing radical cystectomy for bladder cancer: results of a contemporary cystectomy series from M.D. Anderson Cancer Center. J Urol 1997; 157(6): 2120– 2123.
17. Maralani S, Wood DP Jr, Grignon DM et al. Incidence of urethral involvement in female bladder cancer: an anatomic pathologic study. Urology 1997; 50(4): 537– 541.
18. Stenzl A, Draxl H, Posch B et al. The risk of urethral tumors in female bladder cancer: can the urethra be used for orthotopic reconstruction of the lower urinary tract? J Urol 1995; 153(3 Pt 2): 950– 955.
19. Ali- El- Dein B, Abdel-Latif M, Ashamallah A et al. Local urethral recurrence after radical cystectomy and orthotopic bladder substitution in women: a prospective study. J Urol 2004; 171(1): 275– 278.
20. Steers WD. Voiding dysfunction in the orthotopic neobladder. World J Urol 2000; 18(5): 330– 337.
21. Hugonnet CL, Danuser H, Springer JP et al. Decreased sensitivity in the membranous urethra after orthotopic ileal bladder substitute. J Urol 1999; 161(2): 418– 421.
22. Granberg CF, Boorjian SA, Crispen PL et al. Functional and oncological outcomes after orthotopic neobladder reconstruction in women. BJU Int 2008; 102(11): 1551– 1555. doi: 10.1111/ j.1464‑ 410X.2008.07909.x.
23. Hautmann RE, Volkmer BG, Schumacher MC et al. Long‑term results of standard procedures in urology: the ileal neobladder. World J Urol 2006; 24(3): 305– 314.
24. Hautmann RE, Abol– Enein H, Hafez K et al. Urinary diversion. Urology 2007; 69 (1 Suppl): 17– 49.
25. Cancrini A, De Carli P, Fattahi H et al. Orthotopic ileal neobladder in female patients after radical cystectomy: 2‑year experience. J Urol 1995; 153(3 Pt 2): 956– 958.
26. Mills RD, Studer UE. Female ortotopic bladder substitution: a good operation in the right circumstances. J Urol 2000; 163(5): 1501– 1504.
27. Stenzl A, Jarolim L, Coloby P et al. Urethra– sparing cystectomy and orthotopic urinary diversion in women with malignant pelvic tumors. Cancer 2001; 92(7): 1864– 1871.
28. Chang SS, Cole E, Cookson MS et al. Preservation of the anterior vaginal wall during female radical cystectomy with orthotopic urinary diversion: technique and results. J Urol 2002; 168(4 Pt 1): 1442– 1445.
29. Lee CT, Hafez KS, Sheffield JH et al. Orthotopic bladder substitution in women: nontraditional applications. J Urol 2004; 171(4): 1585– 1588.
30. Nesrallah LJ, Almeida FG, Dall’oglio MF et al. Experience with the orthotopic ileal neobladder in women: a mid‑term follow‑up. BJU Int 2005; 95(7): 1045– 1047.
31. Puppo P, Introini C, Calvi P et al. Prevention of chronic urinary retention in orthotopic bladder replacement in the female. Eur Urol 2005; 47(5): 674– 678.
32. Miyake H, Furukawa J, Muramaki M et al. Orthotopic bladder substitution following radical cystectomy in women: comparative study between sigmoid and ileal neobladders. Urol Oncol 2012; 30(1): 38– 43. doi: 10.1016/ j.urolonc.2009.11.006.
33. Stein JP, Penson DF, Lee C et al. Long‑term oncological outcomes in women undergoing radical cystectomy and orthotopic diversion for bladder cancer. J Urol 2009; 181(5): 2052– 2058; discussion 2058– 2059. doi: 10.1016/ j.juro.2009.01.020.
34. Koie T, Hatakeyama S, Yoneyama T et al. Uterus- , fallopian tube- , ovary- , and vagina- sparing cystectomy followed by U- shaped ileal neobladder construction for female bladder cancer patients: oncological and functional outcomes. Urology 2010; 75(6): 1499– 1503. doi: 10.1016/ j.urology.2009.08.083.
35. Yang G, Whitson JM, Breyer BN et al. Oncological and functional outcomes of radical cystectomy and orthotopic bladder replacement in women. Urology 2011; 77(4): 878– 883. doi: 10.1016/ j.urology.2010.08.065.
36. Finley DS, Lee U, McDonough D et al. Urinary retention after orthotopic neobladder substitution in females. J Urol 2011; 186(4): 1364– 1369. doi: 10.1016/ j.juro.2011.05.069.
37. Volkmer BG, Gschwend JE, Herkommer K et al. Cystectomy and orthotopic ileal neobladder: the impact on female sexuality. J Urol 2004; 172(6 Pt 1): 2353– 2357.
38. El- Bahnasawy MS, Osman Y, El- Hefnawy Aet al. Radical cystectomy and urinary diversion in women: impact on sexual function. Scand J Urol Nephrol 2011; 45(5): 332– 338. doi: 10.3109/ 00365599. 2011.585621.
39. Bjerre BD, Johansen C, Steven K. A questionnaire study of sexological problems following urinary diversion in the female patient. Scand J Urol Nephrol 1997; 31(2): 155– 160.
40. Zippe CD, Raina R, Shah AD et al. Female sexual dysfunction after radical cystectomy: a new outcome measure. Urology 2004; 63(6): 1153– 1157.
41. Horenblas S, Meinhardt W, Ijzerman W et al. Sexuality preserving cystectomy and neobladder: initial results. J Urol 2001; 166(3): 837– 840.
42. Ali- El- Dein B, Mosbah A, Osman Y et al. Preservation of the internal genital organs during radical cystectomy in selected women with bladder cancer: a report on 15 cases with long term follow‑up. Eur J Surg Oncol 2013; 39(4): 358– 364. doi: 10.1016/ j.ejso.2013.02.004.
43. Bhatt A, Nandipati K, Dhar N et al. Neurovascular preservation in orthotopic cystectomy: impact on female sexual function. Urology 2006; 67(4): 742– 745.
44. Ali- El- Dein B. Oncological outcome after radical cystectomy and orthotopic bladder substitution in women. Eur J Surg Oncol 2009; 35(3): 320– 325. doi: 10.1016/ j.ejso.2008.03.005.
45. Wu SD, Simma- Chang V, Stein JP. Pathologic guidelines for orthotopic urinary diversion in women with bladder cancer: a review of the literature. Rev Urol 2006; 8(2): 54– 60.
46. Ward AM, Olencki T, Peerboom D et al. Should continent diversion be performed in patients with locally advanced bladder cancer? Urology 1998; 51(2): 232– 236.
47. Tefilli MV, Gheiler EL, Tiguert R et al. Urinary diversion‑related outcome in patients with pelvic recurrence after radical cystectomy for bladder cancer. Urology 1999; 53(5): 999– 1004.
48. Skinner EC. Quality of life with reconstruction. Semin Urol Oncol 2001; 19(1): 56– 58.
49. Hautmann RE, de Petriconi R, Gottfried HW et al. The ileal neobladder: complications and functional results in 363 patients after 11 years of follow up. J Urol 1999; 161(2): 422– 427.
50. Henningsohn L, Steven K, Kallestrup EB et al. Distressful symptoms and well‑being after radical cystectomy and orthotopic bladder substitution compared with a matched control population. J Urol 2002; 168(1): 168– 174; discussion 174– 175.
51. Somani BK, Gimlin D, Fayers P et al. Quality of life and body image for bladder cancer patients undergoing radical cystectomy and urinary diversion – a prospective cohort study with a systematic review of literature. Urology 2009; 74(5): 1138– 1143. doi: 10.1016/ j.urology.2009.05.087.
52. Gilbert SM, Wood DP, Dunn RL et al. Measuring health‑related quality of life outcomes in bladder cancer patients using the Bladder Cancer Index (BCI). Cancer 2007; 109(9): 1756– 1762.
53. Hedgepeth RC, Gilbert SM, He C et al. Body image and bladder cancer specific quality of life in patients with ileal conduit and neobladder urinary diversions. Urology 2010; 76(3): 671– 675. doi: 10.1016/ j.urology.2010.01.087.
54. Hart S, Skinner EC, Meyerowitz BE et al. Quality of life after radical cystectomy for bladder cancer in patients with an ileal conduit, cutaneous or urethral kock pouch. J Urol 1999; 162(1): 77– 81.
Labels
Paediatric urologist UrologyArticle was published in
Urological Journal
2014 Issue 2
Most read in this issue
- Active approach to prostate cancer detection – what is reasonable and what may cause harm
- Prostate cancer – from hormonal dependency to castration resistant cancer
- Transrectal high-intensity focused ultrasound for the treatment of localized prostate cancer
- Erectile dysfunction and its treatment – pharmacological and clinical profile of avanafil