Effect of neurovascular bundle sparing radical cystectomy on post-operative continence and sexual function: A systematic review and meta-analysis

被引:6
|
作者
Xiong, Xingyu [1 ,2 ]
Qiu, Shi [1 ,2 ,3 ]
Yi, Xianyanling [1 ,2 ]
Jin, Kun [1 ,2 ]
Xu, Hang [1 ,2 ]
Lei, Hanran [1 ,2 ]
Bai, Shengjiang [1 ,2 ]
Peng, Ge [1 ,2 ]
Yang, Lu [1 ,2 ]
Wei, Qiang [1 ,2 ]
机构
[1] Sichuan Univ, West China Hosp, Ctr Biomed Big Data, Dept Urol, Chengdu, Peoples R China
[2] Sichuan Univ, West China Hosp, Inst Urol, Natl Clin Res Ctr Geriatr, Chengdu, Peoples R China
[3] Sichuan Univ, West China Hosp, Ctr Biomed Big Data, Chengdu, Peoples R China
基金
中国国家自然科学基金; 中国博士后科学基金;
关键词
cancer and carcinogenesis; hypogonadism; URINARY CONTINENCE; ERECTILE FUNCTION; CYSTOPROSTATECTOMY; PRESERVATION; NEOBLADDER;
D O I
10.1111/andr.12898
中图分类号
R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
摘要
Background It is unclear whether the neurovascular bundle (NVB) sparing could improve post-operative urinary continence and potency. Furthermore, concern remains regarding the impact of nerve-sparing (NS) radical cystectomy (RC) on oncological outcomes. Objectives The primary objective of this meta-analysis was to evaluate whether in men undergoing NS RC could improve post-operative urinary continence and potency. The secondary objective was to assess whether NS RC could compromise the oncological control. Materials and methods A systematic search of the PubMed and Web of Science was performed in February 2020, yielding 1446 unique records. A total of 13 comparative cohort studies were included. Risk of bias in each study was assessed separately by two authors using the Newcastle-Ottawa Scale (NOS). Results Data from 921 participants in 12 studies were synthesized in the present meta-analysis. Meta-analysis revealed that NS compared with non-nerve sparing (NNS) results in improved post-operative potency, daytime continence, and nocturnal continence. RRs were 9.35 (P < .00001) in potency, 1.11 (P = .045) in daytime continence, and 1.33 (P = .002) in nocturnal continence, respectively. Furthermore, no differences were found in the included studies reporting oncological outcomes. RRs were 0.88 (P = .61) in local and/or distant recurrence between two groups. A sensitivity analysis of prospective studies indicated consistent results. Discussion and conclusion This meta-analysis indicates that NS RC can improve post-operative potency, and daytime and nocturnal urinary continence, without compromising oncological control, compared with NNS RC in men.
引用
收藏
页码:221 / 232
页数:12
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