BJU international · 2026
Contemporary practice patterns in female radical cystectomy: results of a UK and Ireland survey.
СтатьяНазвание и аннотация: Перевод в очереди
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Day Elizabeth, Bizzarri Francesco Pio, Waine Elizabeth, Martin Rebecca, Nelson Adam W, Colquhoun Alexandra J, Burden Helena, Ayres Benjamin, Hanchanale Vishwanath, Aning Jonathan, Douglas James, Lobo Niyati
Аннотация
OBJECTIVE: To characterise contemporary practice patterns in female radical cystectomy (RC) across the UK and Ireland, focusing on preoperative counselling, operative strategies, and postoperative care.
SUBJECTS AND METHODS: A 36-item survey was distributed to consultant urologists performing RC, identified via the British Association of Urological Surgeons (BAUS) and Cancer Alliances. The questionnaire addressed surgeon demographics, preoperative assessment and counselling, operative decision-making including organ- and nerve-sparing techniques, and survivorship care. Responses were analysed descriptively; group comparisons were made using the Wilcoxon rank-sum and Fisher's exact tests.
RESULTS: A total of 64 surgeons responded (56.1% [64/114]), representing 41 cystectomy centres (70.7% [41/58]). Preoperative assessment of sexual activity (68.8%) and menopausal status (78.1%) was common, whereas sexual orientation (15.6%) and prolapse (26.6%) were rarely addressed. Female surgeons were significantly more likely to enquire about menopausal status (P = 0.025). Counselling on sexual dysfunction (98.4%) and vaginal shortening (96.9%) was routine, but other complications, including prolapse (68.8%), menopause (82.8%), or fistula (6.3%), were inconsistently discussed. Organ-sparing practice varied: 28.1% rarely or never performed organ preservation, citing oncological concerns. High-volume centres were more likely to offer organ-sparing RC (P = 0.013). Over half reported inadequate access to female-specific rehabilitation services, with most centres lacking formal pathways for vaginal complications.
CONCLUSIONS: Female RC practice across the UK and Ireland is heterogeneous, with clear gaps in preoperative counselling, uptake of organ-sparing techniques, and survivorship care. There is an urgent need for standardised, evidence-based pathways and consensus guidance to optimise outcomes for female patients.
SUBJECTS AND METHODS: A 36-item survey was distributed to consultant urologists performing RC, identified via the British Association of Urological Surgeons (BAUS) and Cancer Alliances. The questionnaire addressed surgeon demographics, preoperative assessment and counselling, operative decision-making including organ- and nerve-sparing techniques, and survivorship care. Responses were analysed descriptively; group comparisons were made using the Wilcoxon rank-sum and Fisher's exact tests.
RESULTS: A total of 64 surgeons responded (56.1% [64/114]), representing 41 cystectomy centres (70.7% [41/58]). Preoperative assessment of sexual activity (68.8%) and menopausal status (78.1%) was common, whereas sexual orientation (15.6%) and prolapse (26.6%) were rarely addressed. Female surgeons were significantly more likely to enquire about menopausal status (P = 0.025). Counselling on sexual dysfunction (98.4%) and vaginal shortening (96.9%) was routine, but other complications, including prolapse (68.8%), menopause (82.8%), or fistula (6.3%), were inconsistently discussed. Organ-sparing practice varied: 28.1% rarely or never performed organ preservation, citing oncological concerns. High-volume centres were more likely to offer organ-sparing RC (P = 0.013). Over half reported inadequate access to female-specific rehabilitation services, with most centres lacking formal pathways for vaginal complications.
CONCLUSIONS: Female RC practice across the UK and Ireland is heterogeneous, with clear gaps in preoperative counselling, uptake of organ-sparing techniques, and survivorship care. There is an urgent need for standardised, evidence-based pathways and consensus guidance to optimise outcomes for female patients.