BACKGROUND: In this paper, we examine contemporary utilization rates and determinants of neobladder (NB) after radical cystectomy (RC) relative to ileal conduit (IC), as well as provide an updated assessment of postoperative morbidity and mortality between NB and IC. METHODS: Relying on the Nationwide Inpatient Sample (NIS), we abstracted patients who underwent RC between 2000 and 2010. Subsequently, NB and IC recipients were identified. Use of NB was assessed after accounting for case-mix. Propensity-based matched analyses were used to account for treatment selection biases. Generalized linear regression analyses focused on intra- and postoperative complications, prolonged length of stay, blood transfusions and in-hospital mortality. RESULTS: The utilization rate of NB was 6.9% in 2000 and 9.1% in 2010 (p < 0.001). Younger, healthier, privately-insured and wealthier male individuals were more likely to receive a NB. High-volume hospitals were more likely to offer NB. In the post-propensity matched cohort, urinary diversion type failed to be significantly associated with the examined endpoints, except for intra- and postoperative complications (IC vs. NB odds ratio [OR]: 1.15, p = 0.04). INTERPRETATION: Despite comparable morbidity and mortality odds between NB and IC, as of the most contemporary year of the study (2010), IC remains the preferred urinary diversion type. Several sociodemographic factors were associated with NB.
BACKGROUND: In this paper, we examine contemporary utilization rates and determinants of neobladder (NB) after radical cystectomy (RC) relative to ileal conduit (IC), as well as provide an updated assessment of postoperative morbidity and mortality between NB and IC. METHODS: Relying on the Nationwide Inpatient Sample (NIS), we abstracted patients who underwent RC between 2000 and 2010. Subsequently, NB and IC recipients were identified. Use of NB was assessed after accounting for case-mix. Propensity-based matched analyses were used to account for treatment selection biases. Generalized linear regression analyses focused on intra- and postoperative complications, prolonged length of stay, blood transfusions and in-hospital mortality. RESULTS: The utilization rate of NB was 6.9% in 2000 and 9.1% in 2010 (p < 0.001). Younger, healthier, privately-insured and wealthier male individuals were more likely to receive a NB. High-volume hospitals were more likely to offer NB. In the post-propensity matched cohort, urinary diversion type failed to be significantly associated with the examined endpoints, except for intra- and postoperative complications (IC vs. NB odds ratio [OR]: 1.15, p = 0.04). INTERPRETATION: Despite comparable morbidity and mortality odds between NB and IC, as of the most contemporary year of the study (2010), IC remains the preferred urinary diversion type. Several sociodemographic factors were associated with NB.
Authors: Christopher B Anderson; Michael S Cookson; Sam S Chang; Peter E Clark; Joseph A Smith; Melissa R Kaufman Journal: J Urol Date: 2012-05-15 Impact factor: 7.450
Authors: Thérèse A Stukel; Elliott S Fisher; David E Wennberg; David A Alter; Daniel J Gottlieb; Marian J Vermeulen Journal: JAMA Date: 2007-01-17 Impact factor: 56.272
Authors: Simon P Kim; Stephen A Boorjian; Nilay D Shah; R Jeffrey Karnes; Christopher J Weight; James P Moriarty; Matthew K Tollefson; Nathan D Shippee; Igor Frank Journal: BJU Int Date: 2012-03-22 Impact factor: 5.588
Authors: Richard E Hautmann; Hassan Abol-Enein; Thomas Davidsson; Sigurdur Gudjonsson; Stefan H Hautmann; Henriette V Holm; Cheryl T Lee; Frederik Liedberg; Stephan Madersbacher; Murugesan Manoharan; Wiking Mansson; Robert D Mills; David F Penson; Eila C Skinner; Raimund Stein; Urs E Studer; Joachim W Thueroff; William H Turner; Bjoern G Volkmer; Abai Xu Journal: Eur Urol Date: 2012-08-31 Impact factor: 20.096
Authors: M Sun; F Abdollah; S F Shariat; J Schmitges; Q-D Trinh; Z Tian; C Jeldres; A Abdo; M Bianchi; A Briganti; F Montorsi; P Perrotte; P I Karakiewicz Journal: Eur J Surg Oncol Date: 2011-10-13 Impact factor: 4.424
Authors: F Roghmann; M Gockel; J Schmidt; J Hanske; N von Landenberg; B Löppenberg; K Braun; C von Bodman; J Pastor; J Palisaar; J Noldus; M Brock Journal: Urologe A Date: 2015-04 Impact factor: 0.639
Authors: Louis Lenfant; Gregory Verhoest; Riccardo Campi; Jérôme Parra; Vivien Graffeille; Alexandra Masson-Lecomte; Dimitri Vordos; Alexandre de La Taille; Mathieu Roumiguie; Marine Lesourd; Lionel Taksin; Vincent Misraï; Pietro Grande; Christophe Vaessen; Guillaume Ploussard; Benjamin Granger; Morgan Rouprêt Journal: World J Urol Date: 2018-05-09 Impact factor: 4.226
Authors: Nicholas J Farber; Izak Faiena; Viktor Dombrovskiy; Alexandra L Tabakin; Brian Shinder; Rutveej Patel; Sammy E Elsamra; Thomas L Jang; Eric A Singer; Robert E Weiss Journal: Bladder Cancer Date: 2018-01-20
Authors: Liesbeth Demaegd; Maarten Albersen; Tim Muilwijk; Uros Milenkovic; Lisa Moris; Wouter Everaerts; Hendrik Van Poppel; Frank Van der Aa; Steven Joniau; Murat Akand Journal: Transl Androl Urol Date: 2020-12