biostudies-literatureUnknown12(1)Desai S<h4>Background</h4>Radical cystectomy (RC) with urinary diversion remains the standard of care for muscle invasive bladder cancer. While metabolic acidosis (MA) after RC is common, the relationship between MA, post-operative complications, and the impact of bicarbonate supplementation remains unclear.<h4>Objective</h4>To review the role of bicarbonate therapy for MA following RC.<h4>Methods</h4>We performed a comprehensive systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines analyzing MA after RC. We included randomized controlled trials and cohort studies that reported metabolic acidosis complications and studies that utilized bicarbonate therapy peri-operatively. Our primary outcome was metabolic acidosis or role of metabolBladder cancer (Amsterdam, Netherlands)23523735261424587https://www.ebi.ac.uk/biostudies/studies/S-EPMC12909775biostudies-literatureSystematic review: The role of bicarbonate therapy after urinary diversion.PMC12909775Tan HJSmith AGessner KHFrisbie JMoreton ENielsen MDesai SBjurlin MfalseSystematic review: The role of bicarbonate therapy after urinary diversion.<h4>Background</h4>Radical cystectomy (RC) with urinary diversion remains the standard of care for muscle invasive bladder cancer. While metabolic acidosis (MA) after RC is common, the relationship between MA, post-operative complications, and the impact of bicarbonate supplementation remains unclear.<h4>Objective</h4>To review the role of bicarbonate therapy for MA following RC.<h4>Methods</h4>We performed a comprehensive systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines analyzing MA after RC. We included randomized controlled trials and cohort studies that reported metabolic acidosis complications and studies that utilized bicarbonate therapy peri-operatively. Our primary outcome was metabolic acidosis or role of metabol2026-01-01T00:00:00Z2026 Jan-Mar2026-07-16T05:17:43.674Z2026-07-09T13:10:21.561ZS-EPMC129097754171020910.1177/23523735261424587