The Influence of Urinary Diversion Type on Body Image and Decision Regret Following Radical Cystectomy: A Systematic Review
Abstract
BACKGROUND AND OBJECTIVE: The choice between different urinary diversion types carries distinct implications for physical appearance and psychosocial outcomes. This systematic review aims to synthesize current evidence on how different urinary diversion types influence patients' body image and decision regret.
METHODS: In this prospectively registered systematic review (CRD420251079300), we searched MEDLINE, Embase, and Web of Science in June 2025 for studies reporting body image and decision regret outcomes in patients undergoing urinary diversion after radical cystectomy for bladder cancer. Data were synthesized descriptively, and the risk of bias was assessed using the Risk Of Bias in Non-randomized Studies-of Interventions (ROBINS-I) tool.
KEY FINDINGS AND LIMITATIONS: Of 1837 records screened, 31 studies comprising 5180 patients were included: 24 assessed body image (n = 4552), six decision regret (n = 579), and one both (n = 49). Diversion types comprised orthotopic neobladder (n = 1848), ileal conduit (n = 2970), continent cutaneous diversion (n = 61), cutaneous ureterostomy (n = 206), and ureterosigmoidostomy (n = 95). Most studies evaluated body image using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Bladder Cancer Module (EORTC QLQ-BLM30; 13 studies) or Body Image Scale (seven studies). Decision regret was measured via the Decision Regret Scale (two studies) or custom questionnaires (five studies). Among 17…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 5,180 participants or records.
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