title: Health related quality of life (HRQoL) after cystectomy: comparison between orthotopic neobladder and ileal conduit diversion.
abstract: BACKGROUND
  Radical cystectomy and urinary diversion carries a high morbidity. Quality of life and body image are important considerations for urinary diversion (UD). We wanted to conduct a systematic review of literature to see which form UD offers a better quality of life (QoL).
  
  
  METHODS
  We searched MEDLINE, Pubmed, EMBASE, CINAHL and the Cochrane library for studies using the following key words: 'quality of life' and 'ileal conduit', 'orthotopic neobladder', 'continent diversion' and 'urinary diversion'. All English language articles on UD surgery were included in the original search from 1990 to 2014. To improve the quality of evidence, we stratified our inclusion criteria into studies that report on QoL in both forms of UD using at least one validated questionnaire.
  
  
  RESULTS
  Twenty-one studies (2285 patients) were included in our study all of which used at least one validated tool. The most frequently used tools were the SF-36, EORTC QLQ-C30 and FACT BL (10, 8, 5 studies respectively). None of the studies were randomised and only 4 studies were prospectively designed. Sixteen studies reported no difference in QoL between the two types of urinary diversion and four studies reported a better QoL with orthotopic neobladder of which 2 studies had younger and fitter patients. On the other hand, one study reported a better QoL in ileal conduit patients.
  
  
  CONCLUSIONS
  Orthotopic neobladder urinary diversion shows a marginally better quality of life scores compared to ileal conduit diversion especially when considering younger and fitter patients.
authors.affiliation: Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK.
authors.forename: A S
authors.initials: AS
authors.lastname: Ali
authors.affiliation: Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK.
authors.forename: M C
authors.initials: MC
authors.lastname: Hayes
authors.affiliation: Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK.
authors.forename: B
authors.initials: B
authors.lastname: Birch
authors.affiliation: Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK.
authors.forename: T
authors.initials: T
authors.lastname: Dudderidge
authors.affiliation: Department of Urology, University Hospital Southampton NHS Trust, Southampton, UK. Electronic address: bhaskarsomani@yahoo.com.
authors.forename: B K
authors.initials: BK
authors.lastname: Somani
mesh_terms: D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D006304:Health Status; D006801:Humans; D007082:Ileum / Q000601:surgery; D011788:Quality of Life; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent
keywords: Ileal conduit; Orthotopic neobladder; Quality of life; Urinary diversion