Effect of urethral lengthening on voiding pattern & continence after radical cystectomy with orthotopic diversion

Abstract

Bladder cancer is the 7th most common diagnosed cancer in male population worldwide, but it drops to 11th when both genders are considered. The worldwide age-standardised incidence rate (per 100, 000 person/years) is 9.0 for men and 2.2 for women. In the European Union, the age-standardised incidence rate is 19.1 for men and 4.0 for women Radical cystectomy with pelvic lymphadenectomy is the standard treatment for muscle-invasive bladder cancer (stage T2 and above). Recent interest in patients’ quality of life (QoL) has promoted the trend toward bladder-preserving treatment modalities. Performance status (PS) and age influence the choice of primary therapy, as well as the type of urinary diversion, with cystectomy being reserved for younger patients without concomitant disease and with a better PS. A comprehensible discussion with the patient about all options for urinary diversion as well as the potential short- and long-term risks and the beneficial effects of each type of diversion is mandatory for improved postoperative compliance and functional outcomes. Controversy remains regarding age, radical cystectomy and the type of urinary diversion.. It is particularly important to evaluate the function and QoL of elderly patients using a standardised geriatric assessment, as well as carrying out a standard medical evaluation.