Skip to main content
Top
Published in: BMC Urology 1/2018

Open Access 01-12-2018 | Research article

Supportive interventions to improve physiological and psychological health outcomes among patients undergoing cystectomy: a systematic review

Authors: Helen Quirk, Derek J. Rosario, Liam Bourke

Published in: BMC Urology | Issue 1/2018

Login to get access

Abstract

Background

Our understanding of effective perioperative supportive interventions for patients undergoing cystectomy procedures and how these may affect short and long-term health outcomes is limited.

Methods

Randomised controlled trials involving any non-surgical, perioperative interventions designed to support or improve the patient experience for patients undergoing cystectomy procedures were reviewed. Comparison groups included those exposed to usual clinical care or standard procedure. Studies were excluded if they involved surgical procedure only, involved bowel preparation only or involved an alternative therapy such as aromatherapy. Any short and long-term outcomes reflecting the patient experience or related urological health outcomes were considered.

Results

Nineteen articles (representing 15 individual studies) were included for review. Heterogeneity in interventions and outcomes across studies meant meta-analyses were not possible. Participants were all patients with bladder cancer and interventions were delivered over different stages of the perioperative period. The overall quality of evidence and reporting was low and outcomes were predominantly measured in the short-term. However, the findings show potential for exercise therapy, pharmaceuticals, ERAS protocols, psychological/educational programmes, chewing gum and nutrition to benefit a broad range of physiological and psychological health outcomes.

Conclusions

Supportive interventions to date have taken many different forms with a range of potentially meaningful physiological and psychological health outcomes for cystectomy patients. Questions remain as to what magnitude of short-term health improvements would lead to clinically relevant changes in the overall patient experience of surgery and long-term recovery.
Appendix
Available only for authorised users
Literature
1.
go back to reference Månsson Å, Colleen S, Hermeren G, Johnson G. Which patients will benefit from psychosocial intervention after cystectomy for bladder cancer? Br J Urol. 1997;80(1):50–7.CrossRefPubMed Månsson Å, Colleen S, Hermeren G, Johnson G. Which patients will benefit from psychosocial intervention after cystectomy for bladder cancer? Br J Urol. 1997;80(1):50–7.CrossRefPubMed
2.
go back to reference Baumgartner RG, Wells N, Chang SS, Cookson MS, Smith JA Jr. Causes of increased length of stay following radical cystectomy. Urol Nurs. 2002;22(5):319.PubMed Baumgartner RG, Wells N, Chang SS, Cookson MS, Smith JA Jr. Causes of increased length of stay following radical cystectomy. Urol Nurs. 2002;22(5):319.PubMed
3.
go back to reference Altobelli E, Buscarini M, Gill HS, Skinner EC. Readmission Rate and Causes at 90-Day after Radical Cystectomy in Patients on Early Recovery after Surgery Protocol. Bladder Cancer. 2017;3(1):51–6.CrossRefPubMedPubMedCentral Altobelli E, Buscarini M, Gill HS, Skinner EC. Readmission Rate and Causes at 90-Day after Radical Cystectomy in Patients on Early Recovery after Surgery Protocol. Bladder Cancer. 2017;3(1):51–6.CrossRefPubMedPubMedCentral
4.
go back to reference Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78(5):606–17.CrossRefPubMed Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation. Br J Anaesth. 1997;78(5):606–17.CrossRefPubMed
5.
go back to reference Palapattu GS, Haisfield-Wolfe ME, Walker JM, Brintzenhofeszoc K, Trock B, Zabora J, Schoenberg M. Assessment of perioperative psychological distress in patients undergoing radical cystectomy for bladder cancer. J Urol. 2004;172(5):1814–7.CrossRefPubMed Palapattu GS, Haisfield-Wolfe ME, Walker JM, Brintzenhofeszoc K, Trock B, Zabora J, Schoenberg M. Assessment of perioperative psychological distress in patients undergoing radical cystectomy for bladder cancer. J Urol. 2004;172(5):1814–7.CrossRefPubMed
6.
go back to reference Azhar RA, Bochner B, Catto J, Goh AC, Kelly J, Patel HD, Pruthi RS, Thalmann GN, Desai M. Enhanced recovery after urological surgery: a contemporary systematic review of outcomes, key elements, and research needs. Eur Urol. 2016;70(1):176–87.CrossRefPubMedPubMedCentral Azhar RA, Bochner B, Catto J, Goh AC, Kelly J, Patel HD, Pruthi RS, Thalmann GN, Desai M. Enhanced recovery after urological surgery: a contemporary systematic review of outcomes, key elements, and research needs. Eur Urol. 2016;70(1):176–87.CrossRefPubMedPubMedCentral
7.
go back to reference Cerantola Y, Valerio M, Persson B, Jichlinski P, Ljungqvist O, Hubner M, Kassouf W, Muller S, Baldini G, Carli F. Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS®) society recommendations. Clin Nutr. 2013;32(6):879–87.CrossRefPubMed Cerantola Y, Valerio M, Persson B, Jichlinski P, Ljungqvist O, Hubner M, Kassouf W, Muller S, Baldini G, Carli F. Guidelines for perioperative care after radical cystectomy for bladder cancer: Enhanced Recovery After Surgery (ERAS®) society recommendations. Clin Nutr. 2013;32(6):879–87.CrossRefPubMed
8.
go back to reference Daneshmand S, Ahmadi H, Schuckman AK, Mitra AP, Cai J, Miranda G, Djaladat H. Enhanced recovery protocol after radical cystectomy for bladder cancer. J Urol. 2014;192(1):50–6.CrossRefPubMed Daneshmand S, Ahmadi H, Schuckman AK, Mitra AP, Cai J, Miranda G, Djaladat H. Enhanced recovery protocol after radical cystectomy for bladder cancer. J Urol. 2014;192(1):50–6.CrossRefPubMed
9.
go back to reference Tyson MD, Chang SS. Enhanced Recovery Pathways Versus Standard Care After Cystectomy: A Meta-analysis of the Effect on Perioperative Outcomes. Eur Urol. 2016;70(6):995–1003.CrossRefPubMedPubMedCentral Tyson MD, Chang SS. Enhanced Recovery Pathways Versus Standard Care After Cystectomy: A Meta-analysis of the Effect on Perioperative Outcomes. Eur Urol. 2016;70(6):995–1003.CrossRefPubMedPubMedCentral
10.
go back to reference Higgins J, Green S: Cochrane handbook for systematic reviews of interventions In., vol. Version 5.1.0 [updated March 2011]: The Cochrane Collaboration; 2011: Available from http://handbook.cochrane.org. Higgins J, Green S: Cochrane handbook for systematic reviews of interventions In., vol. Version 5.1.0 [updated March 2011]: The Cochrane Collaboration; 2011: Available from http://​handbook.​cochrane.​org.
11.
go back to reference Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, Britten N: Guidance on the conduct of narrative synthesis in systematic reviews: A product from the ESRC Methods Programme. In., vol. Version 1. Lancaster University, Lancaster; 2006: b92. Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, Britten N: Guidance on the conduct of narrative synthesis in systematic reviews: A product from the ESRC Methods Programme. In., vol. Version 1. Lancaster University, Lancaster; 2006: b92.
12.
go back to reference Ali NS, Khalil HZ. Effect of psychoeducational intervention on anxiety among Egyptian bladder cancer patients. Cancer Nurs. 1989;12(4):236–42.CrossRefPubMed Ali NS, Khalil HZ. Effect of psychoeducational intervention on anxiety among Egyptian bladder cancer patients. Cancer Nurs. 1989;12(4):236–42.CrossRefPubMed
13.
go back to reference Jensen B, Sondergaard I, Kiesbye B, Jensen J, Kristensen S. Efficacy of preoperative uro-stoma-education on self-efficacy after radical cystectomy; Secondary outcome from a prospective randomized controlled trial. Eur J Oncol Nurs. 2017;28:41–6.CrossRefPubMed Jensen B, Sondergaard I, Kiesbye B, Jensen J, Kristensen S. Efficacy of preoperative uro-stoma-education on self-efficacy after radical cystectomy; Secondary outcome from a prospective randomized controlled trial. Eur J Oncol Nurs. 2017;28:41–6.CrossRefPubMed
14.
go back to reference Banerjee S, Manley K, Shaw B, Lewis L, Cucato G, Mills R, Rochester M, Clark A, Saxton JM. Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial. Support Care Cancer. 2017;26(5):1515–23.PubMed Banerjee S, Manley K, Shaw B, Lewis L, Cucato G, Mills R, Rochester M, Clark A, Saxton JM. Vigorous intensity aerobic interval exercise in bladder cancer patients prior to radical cystectomy: a feasibility randomised controlled trial. Support Care Cancer. 2017;26(5):1515–23.PubMed
15.
go back to reference Merandy K, Morgan MA, Lee R, Scherr DS. Improving self-efficacy and self-care in adult patients with a urinary diversion: A pilot study. Oncol Nurs Forum. 2017;44(3):e90–e100.CrossRefPubMedPubMedCentral Merandy K, Morgan MA, Lee R, Scherr DS. Improving self-efficacy and self-care in adult patients with a urinary diversion: A pilot study. Oncol Nurs Forum. 2017;44(3):e90–e100.CrossRefPubMedPubMedCentral
16.
go back to reference Lee CT, Chang SS, Kamat AM, Amiel G, Beard TL, Fergany A, Karnes RJ, Kurz A, Menon V, Sexton WJ, et al. Alvimopan accelerates gastrointestinal recovery after radical cystectomy: a multicenter randomized placebo-controlled trial. Eur Urol. 2014;66(2):265–72.CrossRefPubMed Lee CT, Chang SS, Kamat AM, Amiel G, Beard TL, Fergany A, Karnes RJ, Kurz A, Menon V, Sexton WJ, et al. Alvimopan accelerates gastrointestinal recovery after radical cystectomy: a multicenter randomized placebo-controlled trial. Eur Urol. 2014;66(2):265–72.CrossRefPubMed
17.
go back to reference Olaru V, Gingu C, Baston C, Manea I, Domnisor L, Preda A, Voinea S, Stefan B, Dudu C, Sinescu I. Applying fast-track protocols in bladder cancer patients undergoing radical cystectomy with ileal urinary diversions-early results of a prospective randomized controlled single center study. Rom J Urol. 2015;14(4):58. Olaru V, Gingu C, Baston C, Manea I, Domnisor L, Preda A, Voinea S, Stefan B, Dudu C, Sinescu I. Applying fast-track protocols in bladder cancer patients undergoing radical cystectomy with ileal urinary diversions-early results of a prospective randomized controlled single center study. Rom J Urol. 2015;14(4):58.
18.
go back to reference Jensen BT, Jensen JB, Laustsen S, Petersen AK, Søndergaard I, Borre M. Multidisciplinary rehabilitation can impact on health-related quality of life outcome in radical cystectomy: secondary reported outcome of a randomized controlled trial. J Multidiscip Healthc. 2014;7:301.CrossRefPubMedPubMedCentral Jensen BT, Jensen JB, Laustsen S, Petersen AK, Søndergaard I, Borre M. Multidisciplinary rehabilitation can impact on health-related quality of life outcome in radical cystectomy: secondary reported outcome of a randomized controlled trial. J Multidiscip Healthc. 2014;7:301.CrossRefPubMedPubMedCentral
19.
go back to reference Jensen B, Laustsen S, Jensen J, Borre M, Petersen A. Exercise-based prehabilitation is feasible and effective in radical cystectomy pathways-secondary results from a randomized controlled trial. J Urol. 2016;195:e652.CrossRef Jensen B, Laustsen S, Jensen J, Borre M, Petersen A. Exercise-based prehabilitation is feasible and effective in radical cystectomy pathways-secondary results from a randomized controlled trial. J Urol. 2016;195:e652.CrossRef
20.
go back to reference Jensen B, Petersen A, Jensen J, Laustsen S, Borre M. Efficacy of a multiprofessional rehabilitation programme in radical cystectomy pathways: a prospective randomized controlled trial. Scand J Urol. 2015;49:133–41.CrossRefPubMed Jensen B, Petersen A, Jensen J, Laustsen S, Borre M. Efficacy of a multiprofessional rehabilitation programme in radical cystectomy pathways: a prospective randomized controlled trial. Scand J Urol. 2015;49:133–41.CrossRefPubMed
21.
go back to reference Porserud A, Sherif A, Tollbäck A. The effects of a physical exercise programme after radical cystectomy for urinary bladder cancer. A pilot randomized controlled trial. Clin Rehabil. 2014;28(5):451–9.CrossRefPubMed Porserud A, Sherif A, Tollbäck A. The effects of a physical exercise programme after radical cystectomy for urinary bladder cancer. A pilot randomized controlled trial. Clin Rehabil. 2014;28(5):451–9.CrossRefPubMed
22.
go back to reference Ghoneim AA, Hegazy MM. The analgesic effect of preoperative pregabalin in radical cystectomy for cancer bladder patients. Chinese-German J Clin Oncol. 2013;12(3):113–7.CrossRef Ghoneim AA, Hegazy MM. The analgesic effect of preoperative pregabalin in radical cystectomy for cancer bladder patients. Chinese-German J Clin Oncol. 2013;12(3):113–7.CrossRef
23.
go back to reference Mohamed MA, Othman AH, Abd El-Rahman AM. Analgesic efficacy and safety of peri-operative pregabalin following radical cystectomy: A dose grading study. Egypt J Anaesth. 2016;32(4):513–7.CrossRef Mohamed MA, Othman AH, Abd El-Rahman AM. Analgesic efficacy and safety of peri-operative pregabalin following radical cystectomy: A dose grading study. Egypt J Anaesth. 2016;32(4):513–7.CrossRef
24.
go back to reference Karl A, Buchner A, Becker A, Staehler M, Seitz M, Khoder W, Schneevoigt B, Weninger E, Rittler P, Grimm T. A new concept for early recovery after surgery for patients undergoing radical cystectomy for bladder cancer: results of a prospective randomized study. J Urol. 2014;191(2):335–40.CrossRefPubMed Karl A, Buchner A, Becker A, Staehler M, Seitz M, Khoder W, Schneevoigt B, Weninger E, Rittler P, Grimm T. A new concept for early recovery after surgery for patients undergoing radical cystectomy for bladder cancer: results of a prospective randomized study. J Urol. 2014;191(2):335–40.CrossRefPubMed
25.
go back to reference Frees S, Aning J, Black P, Struss W, Bell R, Gleave M, So A. A prospective randomized single-centre trial evaluating an ERAS protocol versus a standard protocol for patients treated with radical cystectomy and urinary diversion for bladder cancer. Eur Urol Suppl. 2017;16(3):e1024.CrossRef Frees S, Aning J, Black P, Struss W, Bell R, Gleave M, So A. A prospective randomized single-centre trial evaluating an ERAS protocol versus a standard protocol for patients treated with radical cystectomy and urinary diversion for bladder cancer. Eur Urol Suppl. 2017;16(3):e1024.CrossRef
26.
go back to reference Choi H, Kang SH, Yoon DK, Kang SG, Ko HY, Moon DG, Park JY, Joo KJ, Cheon J. Chewing gum has a stimulatory effect on bowel motility in patients after open or robotic radical cystectomy for bladder cancer: a prospective randomized comparative study. Urology. 2011;77(4):884–90.CrossRefPubMed Choi H, Kang SH, Yoon DK, Kang SG, Ko HY, Moon DG, Park JY, Joo KJ, Cheon J. Chewing gum has a stimulatory effect on bowel motility in patients after open or robotic radical cystectomy for bladder cancer: a prospective randomized comparative study. Urology. 2011;77(4):884–90.CrossRefPubMed
27.
go back to reference Roth B, Birkhäuser FD, Zehnder P, Thalmann GN, Huwyler M, Burkhard FC, Studer UE. Parenteral nutrition does not improve postoperative recovery from radical cystectomy: results of a prospective randomised trial. Eur Urol. 2013;63(3):475–82.CrossRefPubMed Roth B, Birkhäuser FD, Zehnder P, Thalmann GN, Huwyler M, Burkhard FC, Studer UE. Parenteral nutrition does not improve postoperative recovery from radical cystectomy: results of a prospective randomised trial. Eur Urol. 2013;63(3):475–82.CrossRefPubMed
28.
go back to reference Deibert CM, Silva MV, RoyChoudhury A, McKiernan JM, Scherr DS, Seres D, Benson MC. A Prospective Randomized Trial of the Effects of Early Enteral Feeding After Radical Cystectomy. Urology. 2016;96:69–73.CrossRefPubMed Deibert CM, Silva MV, RoyChoudhury A, McKiernan JM, Scherr DS, Seres D, Benson MC. A Prospective Randomized Trial of the Effects of Early Enteral Feeding After Radical Cystectomy. Urology. 2016;96:69–73.CrossRefPubMed
29.
go back to reference Vidal Faune A, Arnold N, Vartolomei M, Kiss B, Burkhard FC, Thalmann GN, Roth B. Does postoperative parenteral nutrition after radical cystectomy impact oncological and functional outcomes in bladder cancer patients? European Urology. Supplements. 2016;15(3):e515. Vidal Faune A, Arnold N, Vartolomei M, Kiss B, Burkhard FC, Thalmann GN, Roth B. Does postoperative parenteral nutrition after radical cystectomy impact oncological and functional outcomes in bladder cancer patients? European Urology. Supplements. 2016;15(3):e515.
30.
go back to reference Sprangers M, Cull A, Groenvold M, Bjordal K, Blazeby J, Aaronson NK. The European Organization for Research and Treatment of Cancer approach to developing questionnaire modules: an update and overview. Qual Life Res. 1998;7(4):291–300.CrossRefPubMed Sprangers M, Cull A, Groenvold M, Bjordal K, Blazeby J, Aaronson NK. The European Organization for Research and Treatment of Cancer approach to developing questionnaire modules: an update and overview. Qual Life Res. 1998;7(4):291–300.CrossRefPubMed
31.
go back to reference Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, Pitkin R, Rennie D, Schulz KF, Simel D. Improving the quality of reporting of randomized controlled trials: the CONSORT statement. Jama. 1996;276(8):637–9.CrossRefPubMed Begg C, Cho M, Eastwood S, Horton R, Moher D, Olkin I, Pitkin R, Rennie D, Schulz KF, Simel D. Improving the quality of reporting of randomized controlled trials: the CONSORT statement. Jama. 1996;276(8):637–9.CrossRefPubMed
32.
go back to reference Rammant E, Decaestecker K, Bultijnck R, Sundahl N, Ost P, Pauwels NS, Deforche B, Pieters R, Fonteyne V. A systematic review of exercise and psychosocial rehabilitation interventions to improve health-related outcomes in patients with bladder cancer undergoing radical cystectomy. Clin rehabil. 2017;32(5):594–606.CrossRefPubMed Rammant E, Decaestecker K, Bultijnck R, Sundahl N, Ost P, Pauwels NS, Deforche B, Pieters R, Fonteyne V. A systematic review of exercise and psychosocial rehabilitation interventions to improve health-related outcomes in patients with bladder cancer undergoing radical cystectomy. Clin rehabil. 2017;32(5):594–606.CrossRefPubMed
33.
go back to reference Bourke L, Smith D, Steed L, Hooper R, Carter A, Catto J, Albertsen PC, Tombal B, Payne HA, Rosario DJ. Exercise for men with prostate cancer: a systematic review and meta-analysis. Eur Urol. 2016;69(4):693–703.CrossRefPubMed Bourke L, Smith D, Steed L, Hooper R, Carter A, Catto J, Albertsen PC, Tombal B, Payne HA, Rosario DJ. Exercise for men with prostate cancer: a systematic review and meta-analysis. Eur Urol. 2016;69(4):693–703.CrossRefPubMed
34.
go back to reference Sharma P, Henriksen CH, Zargar-Shoshtari K, Xin R, Poch MA, Pow-Sang JM, Sexton WJ, Spiess PE, Gilbert SM. Preoperative patient reported mental health is associated with high grade complications after radical cystectomy. J Urol. 2016;195(1):47–52.CrossRefPubMed Sharma P, Henriksen CH, Zargar-Shoshtari K, Xin R, Poch MA, Pow-Sang JM, Sexton WJ, Spiess PE, Gilbert SM. Preoperative patient reported mental health is associated with high grade complications after radical cystectomy. J Urol. 2016;195(1):47–52.CrossRefPubMed
Metadata
Title
Supportive interventions to improve physiological and psychological health outcomes among patients undergoing cystectomy: a systematic review
Authors
Helen Quirk
Derek J. Rosario
Liam Bourke
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Urology / Issue 1/2018
Electronic ISSN: 1471-2490
DOI
https://doi.org/10.1186/s12894-018-0382-z

Other articles of this Issue 1/2018

BMC Urology 1/2018 Go to the issue