The impact of orthotopic reconstruction on female sexuality and quality of life after radical cystectomy for non-malignant bladder conditions

Submitted: January 27, 2021
Accepted: April 23, 2021
Published: September 30, 2021
Abstract Views: 1510
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Objective: To review the literature on the impact on female quality of life and sexual function of orthotopic reconstruction after radical cystectomy for non-malignant bladder conditions. Radical cystectomy is commonly required to treat malignant conditions but may also be considered for the treatment of non-malignant diseases. These heterogeneous group of disorders includes interstitial cystitis, painful bladder syndrome, neurogenic bladder, haemorrhagic/ radiation cystitis, endometriosis and refractory genitourinary fistula. Treatment begins with non-invasive medical therapies but, in non-responder cases, a surgical solution should be considered. Such invasive techniques include urinary diversion and reconstructive procedures that have an impact on healthrelated quality of life, physical, social, and mental status.
Materials and methods: This narrative review research was done using the PubMed database up until 2020, July. All papers referring to cystectomy for benign indication were considered.
Results: In comparison to other reconstructive options, orthotopic neobladder allows the restoration of a normal self-image and consequently it is the most suitable procedure when a surgical reconstruction is necessary for non-malignant conditions. However, women can face many disorders that impact on everyday life, such as voiding dysfunction or sexual activity problems.
Conclusions: Scant data is available about quality of life, sexual life and self-perception in women treated by cystectomy for benign conditions and most literature is dedicated to those indicators in cancer patients. More research is needed to understand the tolerability and the quality of life results of the female population affected by benign conditions undergoing this kind of surgical approach.

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Shimogaki H, Okada H, Fujisawa M, et al. Long-term experience with orthotopic reconstruction of the lower urinary tract in women. J Urol. 1999; 161:573-577. DOI: https://doi.org/10.1016/S0022-5347(01)61954-2
Takenaka A, Hara I, Soga H, et al. Assessment of long-term quality of life in patients with orthotopic neobladder followed for more than 5 years. Int Urol Nephrol. 2011; 43:749-754. DOI: https://doi.org/10.1007/s11255-010-9851-3
Steers WD. Voiding dysfunction in the orthotopic neobladder. World J Urol. 2000; 18:324-329. DOI: https://doi.org/10.1007/s003450000146
Hanno P, Dmochowski R. Status of international consensus on interstitial cystitis/bladder pain syndrome/painful bladder syndrome: 2008 snapshot. Neurourol Urodyn. 2009; 28:274-286. DOI: https://doi.org/10.1002/nau.20687
Hanno PM, Burks DA, Clemens JQ, et al. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol. 2011; 185:2162-2170. DOI: https://doi.org/10.1016/j.juro.2011.03.064
Dorsher PT, McIntosh PM. Neurogenic bladder. Adv Urol. 2012;2012:816274. DOI: https://doi.org/10.1155/2012/816274
Amarenco G, Sheikh Ismaël S, Chesnel C, et al. Diagnosis and clinical evaluation of neurogenic bladder. Eur J Phys Rehabil Med. 2017; 53:975-980. DOI: https://doi.org/10.23736/S1973-9087.17.04992-9
Westney OL. The neurogenic bladder and incontinent urinary diversion. Urol Clin North Am. 2010; 37:581-592. DOI: https://doi.org/10.1016/j.ucl.2010.07.003
Numazaki Y, Kumasaka T, Yano N, et al. Further study on acute hemorrhagic cystitis due to adenovirus type 11. N Engl J Med. 1973;289:344-347. DOI: https://doi.org/10.1056/NEJM197308162890704
Dropulic LK, Jones RJ. Polyomavirus BK infection in blood and marrow transplant recipients. Bone Marrow Transplant. 2008;41:11-18. DOI: https://doi.org/10.1038/sj.bmt.1705886
Stillwell TJ, Benson RC. Cyclophosphamide induced hemorrhagic cystitis: A review of 100 patients. Cancer 1988;61:451-457. DOI: https://doi.org/10.1002/1097-0142(19880201)61:3<451::AID-CNCR2820610308>3.0.CO;2-G
Okaneya T, Kontani K, Komiyama I, Takezaki T. Severe cyclophosphamide-induced hemorrhagic cystitis successfully treated by total cystectomy with ileal neobladder substitution: A case report. J Urol. 1993;150:1909-1910. DOI: https://doi.org/10.1016/S0022-5347(17)35932-3
Gokce G, Kilicarslan H, Ayan S, et al. Genitourinary tuberculosis: A review of 174 cases. Scand J Infect Dis. 2002;34:338-340. DOI: https://doi.org/10.1080/00365540110080331
Kulchavenya E. Best practice in the diagnosis and management of urogenital tuberculosis. Ther Adv Urol. 2013;5:143-151. DOI: https://doi.org/10.1177/1756287213476128
Carl P, Stark L. Indications for surgical management of genitourinary tuberculosis. World J Surg. 1997;21:505-510. DOI: https://doi.org/10.1007/PL00012277
Khalaf I, Shokeir A, Shalaby M. Urologic complications of genitourinary schistosomiasis. World J Urol. 2012;30:31-38. DOI: https://doi.org/10.1007/s00345-011-0751-7
Gray DJ, Ross AG, Li YS, McManus DP. Diagnosis and management of schistosomiasis. Bmj. 2011; 342:1-12. DOI: https://doi.org/10.1136/bmj.d2651
Ghoneim MA, Shoukry I. The use of ileum for correction of advanced or complicated bilharzial lesions of the urinary tract. Int Urol Nephrol. 1972; 4:25-33. DOI: https://doi.org/10.1007/BF02081890
Leone Roberti Maggiore U, Ferrero S, Candiani M, et al. Bladder endometriosis: a systematic review of pathogenesis, diagnosis, treatment, impact on fertility, and risk of malignant transformation. Eur Urol. 2017;71:790-807. DOI: https://doi.org/10.1016/j.eururo.2016.12.015
Nezhat CH, Malik S, Osias J, et al. Laparoscopic management of 15 patients with infiltrating endometriosis of the bladder and a case of primary intravesical endometrioid adenosarcoma. Fertil Steril; 2002; 78:872-875. DOI: https://doi.org/10.1016/S0015-0282(02)03332-0
Gschwend JE. Bladder substitution. Curr Opin Urol. 2003;13:477-482. DOI: https://doi.org/10.1097/00042307-200311000-00010
Measuring health-A review of Quality of Life measurement scales. Accessed July 31, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1059623/
Mânsson A, Mânsson W. When the bladder is gone: Quality of life following different types of urinary diversion. World J Urol. 1999;17:211-218. DOI: https://doi.org/10.1007/s003450050135
Stansfeld SA, Roberts R, Foot SP. Assessing the validity of the SF-36 general health survey. Qual Life Res. 1997;6:217-224. DOI: https://doi.org/10.1023/A:1026406620756
Bjerre BD, Johansen C, Steven K. Health-related quality of life after cystectomy: bladder substitution compared with ileal conduit diversion. A questionnaire survey. Br J Urol. 1995; 75:200-205. DOI: https://doi.org/10.1111/j.1464-410X.1995.tb07312.x
Boyd SD, Feinberg SM, Skinner DG, et al. Quality of life survey of urinary diversion patients: comparison of ileal conduits versus continent Kock ileal reservoirs. J Urol. 1987; 138:1386-1389. DOI: https://doi.org/10.1016/S0022-5347(17)43649-4
Aaronson NK, Ahmedzai S, Bergman B, et al. The European organization for research and t reatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365-376. DOI: https://doi.org/10.1093/jnci/85.5.365
Hobisch A, Tosun K, Kinzl J, et al. Quality of life after cystectomy and orthotopic neobladder versus ileal conduit urinary diversion. World J Urol. 2000; 18:338-344. DOI: https://doi.org/10.1007/s003450000147
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; 76:671-675. DOI: https://doi.org/10.1016/j.urology.2010.01.087
Kochakarn W, Lertsithichai P, Pummangura W. Bladder substitution by ileal neobladder for women with interstitial cystitis. Int Braz J Urol. 2007; 33:486-492. DOI: https://doi.org/10.1590/S1677-55382007000400005
Cody JD, Nabi G, Dublin N, et al. Urinary diversion and bladder reconstruction/replacement using intestinal segments for intractable incontinence or following cystectomy. Cochrane Database Syst Rev. 2012; 2012:CD003306 DOI: https://doi.org/10.1002/14651858.CD003306.pub2
Park JM, Montie JE. Mechanisms of incontinence and retention after orthotopic neobladder diversion. Urology. 1998; 51:601-609. DOI: https://doi.org/10.1016/S0090-4295(97)00697-3
Chiang PH, Huang YS, Wu WJ, et al. Orthotopic bladder substitution in women using the ileal neobladder. J Formos Med Assoc. 2000; 99:348-351.
Hautmann RE, Volkmer BG, Schumacher MC, et al. Long-term results of standard procedures in urology: The ileal neobladder. World J Urol. 2006; 24:305-314. DOI: https://doi.org/10.1007/s00345-006-0105-z
Zippe CD, Raina R, Shah AD, et al. Female sexual dysfunction after radical cystectomy: A new outcome measure. Urology. 2004;63:1153-1157. DOI: https://doi.org/10.1016/j.urology.2003.12.034
Modh RA, Mulhall JP, Gilbert SM. Sexual dysfunction after cystectomy and urinary diversion. Nat Rev Urol. 2014;11:445-453. DOI: https://doi.org/10.1038/nrurol.2014.151
Gross T, Meierhans Ruf SD, Meissner C, et al. Orthotopic ileal bladder substitution in women: Factors influencing urinary incontinence and hypercontinence. Eur Urol. 2015; 68:664-671. DOI: https://doi.org/10.1016/j.eururo.2015.05.015
Cohn JA, Large MC, Richards KA, et al. Cystectomy and urinary diversion as management of treatment-refractory benign disease: The impact of preoperative urological conditions on perioperative outcomes. Int J Urol. 2014;21:382-386. DOI: https://doi.org/10.1111/iju.12284
Gobeaux N, Yates DR, Denys P, et al. Supratrigonal cystectomy with Hautmann pouch as treatment for neurogenic bladder in spinal cord injury patients: Long-term functional results. Neurourol Urodyn. 2012; 31:672-676. DOI: https://doi.org/10.1002/nau.21239
Studer UE, Burkhard FC, Schumacher M, et al. Twenty years experience with an ileal orthotopic low pressure bladder substitutelessons to be learned. J Urol. 2006; 176:161-166. DOI: https://doi.org/10.1016/S0022-5347(06)00573-8
Webster GD, Maggio MI. The management of chronic interstitial cystitis by substitution cystoplasty. J Urol. 1989;141:287-91. DOI: https://doi.org/10.1016/S0022-5347(17)40743-9
Peeker R, Aldenborg F, Fall M. The treatment of interstitial cystitis with supratrigonal cystectomy and ileocystoplasty: difference in outcome between classic and nonulcer disease. J Urol. 1998;159:1479-82. DOI: https://doi.org/10.1097/00005392-199805000-00018
Osman NI, Bratt DG, Downey AP, et al. A systematic review of surgical interventions for the treatment of bladder pain syndrome/interstitial cystitis. Eur Urol Focus. 2020; S2405-4569(20)30071-7.
Venn SN, Mundy AR. 'Nerve-sparing' cystectomy in women. Int Urogynecol J Pelvic Floor Dysfunct. 2000;11:237-40. DOI: https://doi.org/10.1007/s001920070032
Chiang PH, Huang YS, Wu WJ, Chiang CP. Orthotopic bladder substitution in women using the ileal neobladder. J Formos Med Assoc. 2000; 99:348-51.
Chong JT, Dolat MT, Klausner AP, et al. The role of cystectomy for non-malignant bladder conditions: a review. Can J Urol. 2014;21:7433-41.

How to Cite

Borghi, C., Manservigi, M., Milandri, E. S., Ippolito, C., Greco, P., & Dell’Atti, L. (2021). The impact of orthotopic reconstruction on female sexuality and quality of life after radical cystectomy for non-malignant bladder conditions. Archivio Italiano Di Urologia E Andrologia, 93(3), 255–261. https://doi.org/10.4081/aiua.2021.3.255