Neobladder versus Ileal Conduit for Urinary Diversion Following Radical Cystectomy: A Systematic Review of Quality of Life

Abstract

Introduction: After radical cystectomy for bladder cancer, urinary diversion is necessary. The main options are an incontinent ileal conduit or a continent orthotopic neobladder. This review compares their impact on health-related quality of life (QoL).

Methods: A systematic search of comparative studies was conducted. We included studies that evaluated QoL using validated instruments in patients who underwent radical cystectomy with either an ileal conduit or a neobladder.

Results: The review of 35 studies showed that overall QoL scores were largely similar between the two groups. However, patients with neobladders reported better body image and higher satisfaction with the method of urinary diversion. Neobladder patients faced challenges with urinary continence (particularly at night), while conduit patients dealt with appliance-related issues.

Discussion: Neither form of diversion is definitively superior in terms of overall QoL. The choice involves a trade-off between the body image advantages of a neobladder and the technical simplicity and reliability of an ileal conduit. Patient preference and motivation are key.

Conclusion: Orthotopic neobladder and ileal conduit offer comparable overall quality of life, but differ significantly in body image perception and specific functional challenges.