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The Type of Urinary Diversion After Radical Cystectomy Significantly Impacts on the Patient’s Quality of Life

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Abstract

Background: In this study, we used a previously well-validated survey to assess the impact of different forms of urinary diversion on overall quality of life in patients with bladder cancer.

Methods: A total of 92 patients, having three different forms of urinary diversion after radical cystectomy, completed by mail the SF-36, a validated quality-of-life survey. All patients had local(regional disease at the time of cystectomy and are currently without evidence of disease. Completed surveys were then analyzed into physical (PCS) and mental (MCS) component quality-of-life scores per published protocols. Results were then compared with published age-based norms.

Results: A total of 38 men who had cystectomy and ileal neobladder had a mean PCS (6SD) of 48.4 (7.8) and a mean MCS of 51.0 (7.4); 16 men and women who had cystectomy and Indiana Pouch had a mean PCS of 48.4 (8.9) and a mean MCS of 55.7 (3.8). None of these results is statistically different from published age- and sex-based population norms. Thirty-eight men who had cystectomy and ileal conduit had a mean PCS of 41.4 (8.5) and a mean MCS of 48.2 (10.7). The PCS is not statistically different from the population-based norm; however, the MCS is significantly decreased from the published norm (P 5.01).

Conclusions: Patients with ileal conduits have significantly decreased mental health quality of life whereas patients with continent urinary diversions do not. Therefore, when not medically contraindicated, patients should be offered a continent diversion as the diversion of choice after cystectomy.

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REFERENCES

  1. Montie JE. Ileal conduit diversion after radical cystectomy: pro. Urology 1997;49:659–662.

    PubMed  CAS  Google Scholar 

  2. Fossa SD, Reitan JB, Ous S, Kaalhus O. Life with an ileal conduit in cystectomized bladder cancer patients: expectations and experience. Scand J Urol Nephrol 1987;21:97–101.

    Article  PubMed  CAS  Google Scholar 

  3. Babaian RJ, Smith DB. Effect of ileal conduit on patients’ activities following radical cystectomy. Urology 1991;37:33–35.

    PubMed  CAS  Google Scholar 

  4. Chadwick DJ, Stower MJ. Life with a urostomy. Br J Urol 1990;65:189–191.

    PubMed  CAS  Google Scholar 

  5. Jones MA, Breckman B, Hendry WF. Life with an ileal conduit: results of questionnaire surveys of patients and urological surgeons. Br J Urol 1980;52:21–25.

    Article  PubMed  CAS  Google Scholar 

  6. Boyd SD, Feinberg SM, Skinner DG, Lieskovsky G, Baron D, Richardson J. Quality of life survey of urinary diversion patients: comparison of ileal conduits versus continent Kock ileal reservoirs. J Urol 1987;138:1386–1389.

    CAS  PubMed  Google Scholar 

  7. Mansson A, Johnson G, Mansson W. Quality of life after cystectomy. Br J Urol 1988;62:240–245.

    CAS  PubMed  Google Scholar 

  8. Bjerre BD, Johansen C, Steven K. Health-related quality of life after cystectomy: bladder substitution compared with ileal conduit diversion: a questionnaire survey. Br J Urol 1995;75:200–205.

    CAS  PubMed  Google Scholar 

  9. Caffo O, Fellin G, Graffer U, Luciani L. Assessment of quality of life after cystectomy or conservative therapy for patients with infiltrating bladder carcinoma. Cancer 1996;78:1089–1097.

    CAS  PubMed  Google Scholar 

  10. Okada Y, Oishi K, Shichiri Y, et al. Quality of life survey of urinary diversion patients: comparison of continent urinary diversion versus ileal conduit. Int J Urol 1997;4:26–31.

    CAS  PubMed  Google Scholar 

  11. Gerharz EW, Weingartner K, Dopatka T, Kohl UN, Basler HD, Riedmiller HN. Quality of life after cystectomy and urinary diversion: results of a retrospective interdisciplinary study. J Urol 1997;158:778–785.

    Article  CAS  PubMed  Google Scholar 

  12. Filipas D, Egle UT, Budenbender C, et al. Quality of life, and health in patients with urinary diversion: a comparison of incontinent versus continent urinary diversion. Eur Urol 1997;32:23–29.

    CAS  PubMed  Google Scholar 

  13. Weijerman PC, Schurmans JR, Hop WCJ, Schroder FH, Ruud Bosch JLH. Morbidity, and quality of life in patients with orthotopic, and heterotopic continent urinary diversion. Urology 1998;51:51–56.

    Article  PubMed  CAS  Google Scholar 

  14. Ware JE, Kosinski M, Keller SD. SF-36 Physical, and Mental Health Summary Scales: A Users Manual. Boston, MA: The Health Institute, 1994.

    Google Scholar 

  15. Penson DF, Litwin MS. Health-Related Quality of Life Patients with Urologic Cancers: AUA Update Series, vol XVI. 1997:34–39, American Urologic Association, Houston, TX.

    Google Scholar 

  16. Bricker EM, Eiseman B. Bladder reconstruction from cecum, and ascending colon following resection of pelvic viscera. Ann Surg 1950;132:77–84.

    PubMed  CAS  Google Scholar 

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Correspondence to Michael S. McGuire MD.

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McGuire, M.S., Grimaldi, G., Grotas, J. et al. The Type of Urinary Diversion After Radical Cystectomy Significantly Impacts on the Patient’s Quality of Life. Ann Surg Oncol 7, 4–8 (2000). https://doi.org/10.1007/s10434-000-0004-2

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  • DOI: https://doi.org/10.1007/s10434-000-0004-2

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