Management of urinary incontinence after radical cystectomy and orthotopic neobladder: A scoping review of international practices.
ShuYing Miao, QingWei He, YuanFeng Zhang and 4 others
PMID 37408112WHAT IT FOUND
No standardised care exists for incontinence after bladder replacement.
Conservative measures and mebeverine help early, but invasive treatments carry high complication risks. Nurses must monitor voiding patterns closely, as continence improves slowly over 12 to 18 months.
Key findings
01There are no evidence-based guidelines for managing urinary incontinence after radical cystectomy and orthotopic neobladder reconstruction.
02Continence is a dynamic process that improves over time, with daytime control often established 6 to 12 months earlier than nighttime control.
03Mebeverine accelerates the development of continence in male patients during the first year after surgery.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review includes a high proportion of low-evidence studies, such as case reports and retrospective chart reviews. There was significant heterogeneity in how incontinence was defined and measured across the included studies. The review excluded conference papers, which may have missed recent clinical practices. Cultural factors may have influenced treatment choices, with Asian patients preferring conservative management and Western patients preferring invasive options, introducing potential selection bias.
Declared interests
The work was supported by the Zhejiang Provincial Medical and Health Technology Project. The authors declared no conflict of interest.
The easy way to misread this
Do not interpret the high rates of continence recovery as immediate results of a single intervention. The review shows that continence is a dynamic process that naturally improves over 12 to 18 months as the neobladder capacity increases, and many patients received multimodal care that cannot be separated into distinct effective components.