Academic Journal
Comparing benign to malignant cystectomy: complications, emergency department utilization, readmissions, and socioeconomic status.
| Title: | Comparing benign to malignant cystectomy: complications, emergency department utilization, readmissions, and socioeconomic status. |
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| Authors: | Sandberg M; Wake Forest University School of Medicine, Winston Salem, NC, USA. maxwell.sandberg@advocatehealth.org., Thole D; Wake Forest University School of Medicine, Winston Salem, NC, USA., Bissette R; Wake Forest University School of Medicine, Winston Salem, NC, USA., Wolff D; Wake Forest University School of Medicine, Winston Salem, NC, USA., Sandberg M; University of Michigan, Ann Arbor, MI, USA., Schwartz L; Wake Forest University School of Medicine, Winston Salem, NC, USA., Weitzman E; Wake Forest University School of Medicine, Winston Salem, NC, USA., Evans R; Wake Forest University School of Medicine, Winston Salem, NC, USA., Rodriguez A; Wake Forest University School of Medicine, Winston Salem, NC, USA.; Wake Forest Comprehensive Cancer Center, Winston Salem, NC, USA. |
| Source: | International urology and nephrology [Int Urol Nephrol] 2026 Jul; Vol. 58 (7), pp. 2429-2436. Date of Electronic Publication: 2025 Dec 25. |
| Publication Type: | Journal Article; Comparative Study |
| Language: | English |
| Journal Info: | Publisher: Springer Country of Publication: Netherlands NLM ID: 0262521 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1573-2584 (Electronic) Linking ISSN: 03011623 NLM ISO Abbreviation: Int Urol Nephrol Subsets: MEDLINE |
| Imprint Name(s): | Publication: Amsterdam : Springer Original Publication: Budapest, Akademiai Kiadó |
| MeSH Terms: | Cystectomy*/adverse effects , Cystectomy*/methods , Patient Readmission*/statistics & numerical data , Emergency Service, Hospital*/statistics & numerical data , Urinary Bladder Neoplasms*/surgery , Postoperative Complications*/epidemiology , Social Class*, Emergency Room Visits/statistics & numerical data ; Humans ; Female ; Male ; Aged ; Retrospective Studies ; Middle Aged ; Socioeconomic Disparities in Health |
| Abstract: | Introduction: Research has often focused on radical cystectomy for bladder cancer; however, there is an entirely different population, namely those who undergo cystectomy for benign, non-cancerous reasons, which requires attention. The purpose of this study was to compare patients who underwent cystectomy for benign (BC) and malignant (MC) reasons, focusing on complications, emergency department (ED) utilization, readmission, and socioeconomic status (SES). Methods: Cystectomies performed at our institution from 2012 to 2025 were reviewed. Patients were divided based on indication into BC versus MC (for bladder cancer with pathologic confirmation). Non-oncologic cystectomies were either for neurogenic bladder, interstitial cystitis/bladder pain syndrome, or "other reasons." Complications were divided into in-house immediately following cystectomy prior to discharge and those occurring within 90 days of discharge. The Memorial Sloan Kettering Cancer Center classification system of cystectomy complications was used to qualify complications. ED utilization and readmissions were charted within the first 90 days of discharge. Area Deprivation Index (ADI) scores, which assign rankings to SES for neighborhoods, were used as a surrogate for patient SES. BC and MC patients were compared. Results: 569 patients were included in the analysis (183 BC and 386 MC). Urinary diversion choice differed between groups, with more cutaneous ureterostomies in MC patients and Indiana Pouches in BC patients (p < 0.001). In-house complications were significantly greater in the benign cohort (51%) compared with the malignant cohort (36%; p < 0.001). ED utilization within 90 days of discharge was greater in BC (51%) relative to MC (34%; p < 0.001) patients, and BC patients were more likely to visit the ED with no readmission (p < 0.001). 69 (40%) patients were readmitted in the BC group, and 67 (17%; p < 0.001) patients were readmitted in the MC group. ADI scores 1-4 (higher SES) were more common in BC patients (p = 0.012). Conclusions: BC patients have greater rates of healthcare utilization compared to those undergoing MC. While recognizing these patient populations are not the same, the causes of these differences call for additional investigation. (© 2025. The Author(s).) |
| Competing Interests: | Declarations. Conflict of interest: The authors declare no competing interests. |
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| Contributed Indexing: | Keywords: Benign; Cystectomy; Emergency department; Readmission; Surgery |
| Entry Date(s): | Date Created: 20251225 Date Completed: 20260626 Latest Revision: 20260726 |
| Update Code: | 20260726 |
| PubMed Central ID: | PMC13309444 |
| DOI: | 10.1007/s11255-025-04972-7 |
| PMID: | 41447427 |
| Database: | MEDLINE |
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