Location
Philadelphia, PA
Start Date
3-5-2023 1:00 PM
End Date
3-5-2023 4:00 PM
Description
Introduction:
Simple cystectomy (SC) may be performed for a variety of non-malignant bladder conditions. However, SC can involve many complications. We seek to characterize the indications for SC including neurogenic bladder, interstitial cystitis, radiation cystitis, and fistulae. We aim to provide an updated analysis of the temporal and demographic trends from 2013-2020.
Methods
The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was reviewed for patients undergoing SC. The non-malignant etiologies for SC were separated into 9 subgroups: anatomical, autoimmune, benign neoplasm, bladder outlet obstruction/ lower urinary tract symptoms / reflux, fistula, infectious, neurogenic, vascular, and other. ANOVA analysis was performed to assess for significant changes in indication frequency. A two-sided Z-test comparing frequencies of SC in 2013 vs 2020 for each subgroup. Statistical significance was accepted at alpha of 0.05.
Results
A total of 1,516 patients met inclusion criteria. Neurogenic bladder, fistula, and vascular were the most common indications with 376 (25%), 259 (17%), and 227 (15%) of patients, respectively (Table 1). The average length of stay (LOS) for neurogenic etiologies was 11.05 days. The trends of neurogenic (p<0.01), other (p=0.003), autoimmune (p=0.011), and fistula (p=0.025) etiologies had a statistically significant decrease from 2013 to 2020 (Table 1).
Discussion
From 2013-2020, the most common indication for SC was neurogenic bladder though there has been a statistically significant decrease in SC from 2013 to 2020. We observed that while cystectomy continues to have long LOS and with high rates of complication, there has been a decrease in frequency with which SC is performed as more conservative management is pursued. While performing cystectomy for non-malignant conditions remains relatively rare, it is important to retrospectively look at the diagnoses that warrant this procedure. This information is of interest to urologists as they consider surgical versus non-surgical management of these benign diseases. The trends identified in this study will help define the prevalence of SC in treating non-malignant disease and the need for future research in this area.
Embargo Period
6-7-2023
Included in
Non-Malignant Etiologies for Cystectomy: Trends from 2013-2020
Philadelphia, PA
Introduction:
Simple cystectomy (SC) may be performed for a variety of non-malignant bladder conditions. However, SC can involve many complications. We seek to characterize the indications for SC including neurogenic bladder, interstitial cystitis, radiation cystitis, and fistulae. We aim to provide an updated analysis of the temporal and demographic trends from 2013-2020.
Methods
The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was reviewed for patients undergoing SC. The non-malignant etiologies for SC were separated into 9 subgroups: anatomical, autoimmune, benign neoplasm, bladder outlet obstruction/ lower urinary tract symptoms / reflux, fistula, infectious, neurogenic, vascular, and other. ANOVA analysis was performed to assess for significant changes in indication frequency. A two-sided Z-test comparing frequencies of SC in 2013 vs 2020 for each subgroup. Statistical significance was accepted at alpha of 0.05.
Results
A total of 1,516 patients met inclusion criteria. Neurogenic bladder, fistula, and vascular were the most common indications with 376 (25%), 259 (17%), and 227 (15%) of patients, respectively (Table 1). The average length of stay (LOS) for neurogenic etiologies was 11.05 days. The trends of neurogenic (p<0.01), other (p=0.003), autoimmune (p=0.011), and fistula (p=0.025) etiologies had a statistically significant decrease from 2013 to 2020 (Table 1).
Discussion
From 2013-2020, the most common indication for SC was neurogenic bladder though there has been a statistically significant decrease in SC from 2013 to 2020. We observed that while cystectomy continues to have long LOS and with high rates of complication, there has been a decrease in frequency with which SC is performed as more conservative management is pursued. While performing cystectomy for non-malignant conditions remains relatively rare, it is important to retrospectively look at the diagnoses that warrant this procedure. This information is of interest to urologists as they consider surgical versus non-surgical management of these benign diseases. The trends identified in this study will help define the prevalence of SC in treating non-malignant disease and the need for future research in this area.