Cystectomy and Ileal Conduit for Neurogenic Lower Urinary Tract Dysfunction: A Systematic Review of Outcomes for Different Surgical Approaches
Bibliographic record
Abstract
OBJECTIVE: To assess the outcomes of cystectomy and ileal conduit for managing neurogenic lower urinary tract dysfunction and compare different surgical approaches (open, laparoscopic, and robotic-assisted). DESIGN, SETTING, AND PARTICIPANTS: This systematic review was conducted in accordance with PRISMA guidelines, and the protocol was registered in the PROSPERO database (CRD42024512893). A systematic search of MEDLINE/PubMed, Embase, and CENTRAL identified original articles reporting surgical outcomes of cystectomy and ileal conduit in adult neuro-urological patients. Our primary outcome was 30-day high-grade complications. Secondary outcomes included perioperative parameters, late complications, quality of life, and kidney function. RESULTS AND LIMITATIONS: Ten studies with a high risk of bias were included, comprising 721 patients. Minimally invasive approaches had longer operative times. Mean blood loss was 872 ± 325 mL for open, 376 ± 62 mL for laparoscopic, and 291 ± 29 mL for the robotic-assisted approach. Reported hospital stay durations varied (open: 21 ± 3.3 days; laparoscopic: 17 ± 5.8 days; robotic-assisted: 13 ± 1.9 days). Early complication rates were similar across approaches (15%-20% for high-grade complications). Late high-grade complication rates ranged from 19% to 26%. Studies reported improved post-operative quality of life and generally stable kidney function, though assessment methods varied considerably. CONCLUSION: Cystectomy with ileal conduit in neurogenic lower urinary tract dysfunction patients is associated with substantial complication rates across all surgical methods. The available evidence is heterogeneous and subject to significant confounding factors. Differences observed between surgical approaches should be interpreted with caution. Prospective comparative studies with standardized reporting are needed to determine the optimal surgical approach for this specific patient population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.035 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.009 |
| Bibliometrics | 0.011 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".