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Tinoco et al. Mini-invasive Surg 2021;5:28 https://dx.doi.org/10.20517/2574-1225.2021.35 Page 9 of 11

[35]
In a study by Ahmadi et al. , self-reported rates of daily urinary leakage reached 39.7%, causing almost half
the patients to need to wear at least 1 pad per day. Nocturnal leakage was even higher (54.7%) with many
[35]
patients needing diapers at night. Notably, most did not report bothersome skin irritation or body odor .
Daytime incontinence of 3%-43% and nighttime incontinence of 0%-42% were the rates reported in a
systematic review of female cystectomized patients. Nerve sparing techniques seem to improve continence,
[38]
but more studies are needed in this area .
Continence rates improve over time for most patients for up to 2 years after surgery, as the neobladder
capacity increases. If incontinence persists, treatment options are diverse, including anti-muscarinic agents
like tolterodine, periurethral collagen injections, bulking agents, urethral slings or external artificial urinary
sphincters, and even trans-obturator taping [39,40] .

CONCLUSION
Radical cystectomy with urinary diversion is undoubtedly the most difficult surgical procedure in urology.
Complication rates are high in the early and late settings, with various complications described in the
literature. There is an urgent need of standardizing complication reporting so different series can be
comparable. This review highlighted some of the most common complications and their possible
management options. Careful patient selection, thorough long-term follow-up and standardization of
complication reporting are mandatory conditions to achieve successful outcomes.

DECLARATIONS
Authors’ contributions
Made substantial contributions to conception and organization of the review and performed literature
review: Laranjo Tinoco C, Lima E

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Both authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2021.

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