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Objectives: To determine and summarize the available data on urinary, sexual, and health‐related quality‐of‐life (HRQOL) outcomes after traditional radical cystectomy (RC), reproductive organ‐preserving RC (ROPRC) and nerve‐sparing RC (NSRC) for bladder cancer (BCa) in female patients. Methods: The PubMed, SCOPUS and Web of Science databases were searched to identify studies reporting functional outcomes in female patients undergoing RC and urinary diversion for the treatment of BCa. The outcomes of interest were voiding function (for orthotopic neobladder [ONB]), sexual function and HRQOL. The following independent variables were derived and included in the meta‐analysis: pooled rate of daytime and nighttime continence/incontinence, and intermittent self‐catheterization (ISC) rates. Analyses were performed separately for traditional, organ‐ and/or nerve‐sparing surgical approaches. Results: Fifty‐three studies comprising 2740 female patients (1201 traditional RC and 1539 organ‐/nerve‐sparing RC, and 264 nerve‐sparing‐alone RC) were eligible for qualitative synthesis; 44 studies comprising 2418 female patients were included in the quantitative synthesis. In women with ONB diversion, the pooled rates of daytime continence after traditional RC, ROPRC and NSRC were 75.2%, 79.3% and 71.2%, respectively. The pooled rate of nighttime continence after traditional RC was 59.5%; this rate increased to 70.7% and 71.7% in women who underwent ROPRC and NSRC, respectively. The pooled rate of ISC after traditional RC with ONB diversion in female patients was 27.6% and decreased to 20.6% and 16.8% in patients undergoing ROPRC and NSRC, respectively. The use of different definitions and questionnaires in the assessment of postoperative sexual and HRQOL outcomes did not allow a systematic comparison. Conclusions: Female organ‐ and nerve‐sparing surgical approaches during RC seem to result in improved voiding function. There is a significant need for well‐designed studies exploring sexual and HRQOL outcomes to establish evidence‐based management strategies to support a shared decision‐making process tailored towards patient expectations and satisfaction. Understanding expected functional, sexual and quality‐of‐life outcomes is necessary to allow individualized pre‐ and postoperative counselling and care delivery in female patients planned to undergo RC. [ABSTRACT FROM AUTHOR]

Objectives: To assess outcomes of transecting vs non‐transecting urethroplasty for bulbar urethral stricture in terms of stricture recurrence rate, sexual dysfunction, and patient‐reported outcome measures (PROMs) related to lower urinary tract (LUT) function. Methods: Electronic literature searches were conducted using PubMed, Cochrane Library, Web of Science and Embase databases. The studied population was limited to men with bulbar urethral stricture included in studies that compared outcomes after transecting and non‐transecting urethroplasty. The main outcome appraised was the stricture recurrence rate. Additionally, the incidence of sexual dysfunction appraised in three domains (erectile function, penile complications, and ejaculatory function) and PROMs related to LUT function after transecting vs non‐transecting urethroplasty were assessed. The pooled risk ratio (RR) respectively for stricture recurrence, erectile dysfunction and penile complications was calculated using a fixed‐effect model with inverse variance method. Results: In all, 694 studies were screened with 72 identified as relevant. Finally, 19 studies were suitable for analysis. The pooled difference between the transecting and non‐transecting groups relating to stricture recurrence was not significant. Overall, the RR was 1.06 (95% confidence interval [CI] 0.82–1.36) and the 95% CI crossed the line of no effect (line RR = 1). Overall, the RR for erectile dysfunction was 0.73 (95% CI 0.49–1.08) and the 95% CI crossed the line of no effect (line RR = 1). Overall, the RR for penile complications was 0.47 (95% CI 0.28–0.76) and the 95% CI did not cross the line of no effect (line RR = 1). Hence, the risk of penile complications was significantly lower in the non‐transecting group. Conclusions: Our analysis of available evidence indicates that both transecting and non‐transecting urethroplasties, are equal in terms of the recurrence rate. On the other hand, non‐transecting techniques are better in terms of sexual function, causing less penile complications. [ABSTRACT FROM AUTHOR]

Objective: To assess whether single immediate intravesical chemotherapy (SIIC) adds value to bladder tumour management in combination with novel optical techniques: enhanced transurethral resection of bladder tumour (TURBT). Methods: A systematic search was performed using the PubMed and Web of Science databases in September 2020 according to the Preferred Reporting Items for Systematic Review and Meta‐analysis (PRISMA) extension statement for network meta‐analyses. Studies that compared recurrence rates among intervention groups (TURBT with photodynamic diagnosis [PDD] ± SIIC, narrow‐band imaging [NBI] ± SIIC, or white‐light cystoscopy [WLC] + SIIC) and a control group (TURBT with WLC alone) were included. We used the Bayesian approach in the network meta‐analysis. Results: Twenty‐two studies (n = 4519) met our eligibility criteria. Out of six different interventions including three different optical techniques, compared to WLC alone, blue‐light cystoscopy (BLC) plus SIIC (odds ratio [OR] 0.349, 95% credible interval [CrI] 0.196–0.601) and BLC alone (OR 0.668, 95% CrI 0.459–0.931) were associated with a significantly lower likelihood of 12‐month recurrence rate. In the sensitivity analysis, out of eight different interventions compared to WLC alone, PDD by 5‐aminolevulinic acid plus SIIC (OR 0.327, 95% CrI 0.159–0.646) and by hexaminolevulinic acid plus SIIC (OR 0.376, 95% CrI 0.172–0.783) were both associated with a significantly lower likelihood of 12‐month recurrence rate. NBI with and without SIIC was not associated with a significantly lower likelihood of 12‐month recurrence rate (OR 0.385, 95% CrI 0.105–1.29 and OR 0.653, 95% CrI 0.343–1.15). Conclusion: Blue‐light cystoscopy during TURBT with concomitant SIIC seems to yield superior recurrence outcomes in patients with non‐muscle‐invasive bladder cancer. The use of PDD was able to reduce the 12‐month recurrence rate; moreover, concomitant SIIC increased this risk benefit by a 32% additional reduction in odds ratio. Although using PDD could reduce the recurrence rate, SIIC remains necessary. Moreover, ranking analysis showed that both PDD and NBI, plus SIIC, were better than these techniques alone. [ABSTRACT FROM AUTHOR]