title: Systematic review and meta-analysis of non RCT's on health related quality of life after radical cystectomy using validated questionnaires: Better results with orthotopic neobladder versus ileal conduit.
abstract: OBJECTIVE
  The current literature on the impact of different urinary diversions on patients' health related quality of life (HR-QoL) showed a marginally better quality of life scores of orthotopic neobladder (ONB) compared to ileal conduit (IC). The aim of this study was to update the review of all relevant published studies on the comparison between ONB and IC.
  
  
  METHODS
  Studies were identified by searching multiple literature databases, including MEDLINE, CINAHL, the Cochrane Library, PubMed Data were synthesized using meta-analytic methods conformed to the PRISMA statement.
  
  
  RESULTS
  The current meta-analysis was based on 18 papers that reported a HR-QoL comparison between IC and ONB using at least a validate questionnaire. Pooled effect sizes of combined QoL outcomes for IC versus ONB showed a slight, but not significant, better QoL in patients with ONB (Hedges' g = 0.150; p = 0.066). Patients with ileal ONB showed a significant better QoL than those with IC (Hedges' g = 0.278; p = 0.000); in case series with more than 65% males, ONB group showed a slight significant better QoL than IC (Hedges' g = 0.190; p = 0.024). Pooled effects sizes of all EORTC-QLQ-C30 aspects showed a significant better QoL in patients with ONB (Hedges' g = 0.400; p = 0.0000).
  
  
  CONCLUSIONS
  This meta-analysis of not-randomized comparative studies on the impact of different types of urinary diversions on HR-QoL showed demonstrated a significant advantage of ileal ONB compared to IC in terms of HR-QoL.
authors.affiliation: University of Verona, Urology Department, Verona, Italy. Electronic address: mariaangela.cerruto@univr.it.
authors.forename: M A
authors.initials: MA
authors.lastname: Cerruto
authors.affiliation: University of Verona, Urology Department, Verona, Italy. Electronic address: karolinedelia@gmail.com.
authors.forename: C
authors.initials: C
authors.lastname: D'Elia
authors.affiliation: Trieste University, Urology Department, Trieste, Italy. Electronic address: siracus@units.it.
authors.forename: S
authors.initials: S
authors.lastname: Siracusano
authors.affiliation: University of Verona, Urology Department, Verona, Italy. Electronic address: xhoagedeschi@gmail.com.
authors.forename: X
authors.initials: X
authors.lastname: Gedeshi
authors.affiliation: University of Verona, Urology Department, Verona, Italy. Electronic address: arianna.mariotto@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Mariotto
authors.affiliation: University of Padua, Urology Department, Padua, Italy. Electronic address: massimo.iafrate@unipd.it.
authors.forename: M
authors.initials: M
authors.lastname: Iafrate
authors.affiliation: University of Verona, TESIS Department, Verona, Italy. Electronic address: mauro.niero@univr.it.
authors.forename: M
authors.initials: M
authors.lastname: Niero
authors.affiliation: University of Verona, TESIS Department, Verona, Italy. Electronic address: cristina.lonardi@univr.it.
authors.forename: C
authors.initials: C
authors.lastname: Lonardi
authors.affiliation: Catholic University Policlinico Gemelli, Urology Department, Rome, Italy. Electronic address: bassipf@rm.unicatt.it.
authors.forename: P
authors.initials: P
authors.lastname: Bassi
authors.affiliation: Trieste University, Urology Department, Trieste, Italy. Electronic address: e.belgrano@fmc.units.it.
authors.forename: E
authors.initials: E
authors.lastname: Belgrano
authors.affiliation: University of Naples, Urology Department, Naples, Italy. Electronic address: ciro.imbimbo@unina.it.
authors.forename: C
authors.initials: C
authors.lastname: Imbimbo
authors.affiliation: Catholic University Policlinico Gemelli, Urology Department, Rome, Italy. Electronic address: marco.racioppi@rm.unicatt.it.
authors.forename: M
authors.initials: M
authors.lastname: Racioppi
authors.affiliation: IRCCS-CRO, Unit of Epidemiology and Biostatistics, Aviano, Italy. Electronic address: talaminir@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Talamini
authors.affiliation: Trieste University, Urology Department, Trieste, Italy. Electronic address: stefanociciliato@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Ciciliato
authors.affiliation: Trieste University, Urology Department, Trieste, Italy. Electronic address: lauratoffoli1@yahoo.it.
authors.forename: L
authors.initials: L
authors.lastname: Toffoli
authors.affiliation: Trieste University, Urology Department, Trieste, Italy. Electronic address: mik.rizzo@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Rizzo
authors.affiliation: Trieste University, Urology Department, Trieste, Italy. Electronic address: visa83@virgilio.it.
authors.forename: F
authors.initials: F
authors.lastname: Visalli
authors.affiliation: University of Naples, Urology Department, Naples, Italy. Electronic address: pverze@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Verze
authors.affiliation: University of Verona, Urology Department, Verona, Italy. Electronic address: walter.artibani@univr.it.
authors.forename: W
authors.initials: W
authors.lastname: Artibani
mesh_terms: D018849:Controlled Clinical Trials as Topic; D015653:Cystectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods / Q000523:psychology*; D016476:Urinary Reservoirs, Continent
keywords: Health related quality of life; Ileal conduit; Meta-analysis; Orthotopic neobladder; Radical cystectomy; Urinary diversion