title: Role of patient-physician dialogue in selecting the type of urinary diversion.
abstract: BACKGROUND
  We analyze patient-physician dialogue prior to radical cystectomy (RC) when choosing the type of urinary diversion (UD).
  
  
  METHODS
  132 patients operated by one surgical team between 2003 and 2005 were included. Physician's recommendation, patient's decision and UD (neobladder (NB) or ileal conduit (IC)) performed were analyzed. Patients were grouped based on age, considering that age is often a limiting factor for NB.
  
  
  RESULTS
  When offered either NB or IC, 85% (49/58) in group I (<70 years) and 55% (12/22) in group II (> or =70 years) elected NB. An IC was suggested for 16% (11/69) in group I and 65% (41/63) in group II. Six patients (2 in group I, 4 in group II) wanted a NB even though an IC was suggested.
  
  
  CONCLUSIONS
  Counseling patients is important. When an IC was suggested, over 80% accepted this advice. When both were offered, younger patients usually elected a NB. Older patients preferred an IC.
authors.affiliation: Department of Urology, University of Miami Miller School of Medicine, Miami, FL 33101, USA.
authors.forename: Devendar
authors.initials: D
authors.lastname: Katkoori
authors.forename: Murugesan
authors.initials: M
authors.lastname: Manoharan
authors.forename: Motoo
authors.initials: M
authors.lastname: Araki
authors.forename: Mark S
authors.initials: MS
authors.lastname: Soloway
mesh_terms: D000368:Aged; D015897:Comorbidity; D003376:Counseling; D015653:Cystectomy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*; D014547:Urinary Diversion / Q000523:psychology*; D016476:Urinary Reservoirs, Continent