Prevention and management of complications following radical cystectomy for bladder cancer.

CONTEXT

This review focuses on the prevention and management of complications following radical cystectomy (RC) for bladder cancer (BCa).

OBJECTIVE

We review the current literature and perform an analysis of the frequency, treatment, and prevention of complications related to RC for BCa.

EVIDENCE ACQUISITION

A Medline search was conducted to identify original articles, reviews, and editorials addressing the relationship between RC and short- and long-term complications. Series examined were published within the past decade. Large series reported on multiple occasions (Lee [1], Meyer [2], and Chang and Cookson [3]) with the same cohorts are recorded only once. Quality of life (QoL) and sexual function were excluded.

EVIDENCE SYNTHESIS

The literature regarding prophylaxis, prevention, and treatment of complications of RC in general is retrospective, not standardised. In general, it is of poor quality when it comes to evidence and is thus difficult to synthesise.

CONCLUSIONS

Progress has been made in reducing mortality and preventing complications of RC. Postoperative morbidity remains high, partly because of the complexity of the procedures. The issues of surgical volume and standardised prospective reporting of RC morbidity to create evidence-based guidelines are essential for further reducing morbidity and improving patients' QoL.