单纯性膀胱切除术（RC）对泌尿、性功能和生殖系统产生不良影响。缓解术后功能性生活质量下降的方法包括保留器官和神经的RC变体；然而，关于女性性别特异性结果的高质量数据仍然稀缺。本研究旨在确定和总结有关女性患者接受传统、保留生殖器官（ROPRC）和神经保留（NSRC）用于膀胱癌（BCa）治疗的RC术后尿道、性和健康相关生活质量（HRQOL）结果的可用数据。我们检索了PubMed、SCOPUS和Web of Science数据库，以识别报道女性患者接受RC和膀胱分流治疗的功能结果的研究。感兴趣的结果包括排便功能（对于正位新膀胱）、性功能和HRQOL。以下自变量被提取并包括在元分析中：白天和夜间完全性/失禁和间歇性自主导尿（ISC）率。针对传统的器官和/或神经保留手术方法分别进行了分析。共有53项研究，包括2,740名女性患者（1,201名接受传统手术，1,539名接受器官/神经保留或264名接受纯神经保留RC），符合定性综合的资格； 共有44项研究，其中包括2,418名女性患者的定量综合分析。在使用正位新膀胱分流术的女性中，传统RC后的白天完全率分别为75.2%、79.3%和71.2%；夜间完全率在传统RC中为59.5%，在接受ROPRC和NSRC的女性中分别增加到70.7%和71.7%。接受传统RC的女性患者ISC的率为27.6%，在接受ROPRC和NSRC的患者中分别降至20.6%和16.8%。在评估术后性和HRQOL结果时使用不同的定义和问卷无法进行系统比较。在RC期间使用保留器官和神经的手术方法似乎可以改善排尿功能。有必要进行设计良好的研究，探讨性和HRQOL结果，以建立基于证据的管理策略，以支持根据患者期望和满意度进行个性化预术和术后咨询和护理交付的共享决策过程。了解术后功能、性和生活质量预期是为计划接受RC的女性患者提供个体化术前和术后咨询和护理的必要条件。本文受版权保护。保留所有权利。

Radical cystectomy (RC) has detrimental effects on the urinary, sexual, and reproductive systems. Approaches to mitigate a decline in postoperative functional quality of life include organ-preserving and nerve-sparing variations of RC; however, high-quality data on gender-specific outcomes in women remain scarce. We aimed to determine and summarize available data on the urinary, sexual, and health-related quality of life (HRQOL) outcomes after traditional, reproductive organ preserving (ROPRC) and nerve-sparing RC (NSRC) for bladder cancer (BCa) in female patients.The PubMed, SCOPUS, and Web of Science databases were searched to identify studies reporting on functional outcomes in female patients undergoing RC and urinary diversion for the treatment of BCa. The outcomes of interest were voiding function (for orthotopic neobladder), sexual function, and HRQOL. The following independent variables were derived and included in the meta-analysis: pooled rate of daytime and nighttime continence/incontinence and intermittent self-catheterization (ISC) rate. Analyses were performed separately for traditional, organ- and/or nerve-sparing surgical approaches.Fifty-three studies comprising 2,740 female patients (1,201 underwent traditional; 1,539 - organ-/NS-sparing, or 264 - NS alone RC) were eligible for qualitative synthesis; 44 studies comprising 2,418 female patients were included in the quantitative synthesis. In women with orthotopic neobladder (ONB) diversion, the pooled rates of daytime continence after traditional, ROPRC and NSRC were 75.2%, 79.3%, and 71.2%, respectively. The pooled rate of nighttime continence after traditional RC was 59.5%; this rate increased to 70.7% and 71.7% in women who underwent ROPRC and NSRC, respectively. The pooled rate of ISC after traditional RC with ONB diversion in female patients was 27.6% and decreased to 20.6% and 16.8% in patients undergoing ROPRC and NSRC, respectively. The use of different definitions and questionnaires in the assessment of postoperative sexual and HRQOL outcomes did not allow a systematic comparison.Female organ- and nerve-sparing surgical approaches during RC seem to result in improved voiding function. There is a significant need for well-designed studies exploring sexual and HRQOL outcomes to establish evidence-based management strategies to support shared decision-making process tailored toward patient expectations and satisfaction. Understanding expected functional, sexual, and quality of life outcomes is necessary to allow individualized pre-and postoperative counseling and care delivery in female patients planned for RC.This article is protected by copyright. All rights reserved.