Introduction
Radical cystectomy is the gold standard management for
high-risk urothelial carcinoma of the bladder. However, it
comes at the expense of high morbidity (20e50% shortterm
and up to 90% long-term morbidity) and not an insignificant
mortality rate (0e5%).1e3 Another complicating
factor is the choice of urinary diversion (UD) and its impact
on quality of life (QoL). Appropriate counselling regarding
the type of urinary diversion and its effect on physical activity
and body image remains an important aspect of
pre-operative discussion.4
There has been an increasing interest in QoL for patients
undergoing radical cystectomy. Most large centres worldwide
are reporting an increasing number of orthotopic neobladder
(ON) diversion compared to the classical technique
of ileal conduit (IC) or continent cutaneous diversion (CCD).
Nevertheless, many centres are still reporting equal
numbers of both types of diversion (Table 1). The aim of
this systematic review is to investigate which of the available
forms of urinary diversion offers a superior QoL after
cystectomy.