Health-Related quality of life with orthotopic neobladder versus ileal conduit according to the SF-36 survey

Fujisawa, Masato; Isotani, Shuji; Gotoh, Akinobu; Okada, Hiroshi; Arakawa, Soichi; Kamidono, Sadao

doi:10.1016/s0090-4295(00)00483-0

Cited by 76 publications

(46 citation statements)

References 13 publications

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“…For patients to make an informed decision they need to know the QoL after surgery that each technique offers. Many studies are reported comparing QoL between ileal conduit diversion and orthotopic neobladder, but with conflicting results [1,[3][4][5][6][7][8][9][10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

“…Apart from functionality and longterm complications, quality of life (QoL) is important when deciding which diversion is appropriate. RC per se affects many domains of the QoL of patients, the most important being those of urinary, sexual and social function [4][5][6][7][8][9][10][11][12][13][14][15]. Even simple daily activities can be altered, especially in elderly people [16].…”

Section: Introductionmentioning

confidence: 99%

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Modified S‐pouch neobladder vs ileal conduit and a matched control population: a quality‐of‐life survey

et al. 2004

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urinary and sexual function and bother was also constructed. RESULTSThere were no differences in the QoL scores among the three groups; group 3 (control) tended to have a better QoL for all domains except emotional functioning. Urinary function was seriously affected in group 1, with more daytime leakage than in groups 2 and 3 (37.8% vs 10%, P = 0.005, and 9.3%, P = 0.01), night loss of urine (39.5% vs 28%, P = 0.07, and 3.7%, P = 0.002) and urine odour (58.6% vs 4%, and 5.5%, both P = 0.001). Patients in group 2 differed from healthy individuals only in night loss of urine. Consequently urinary bother was more pronounced in group 1, as fewer were satisfied (68.9% vs 86% and 83.2%, both P = 0.03). Sexual function was seriously and similarly affected in groups 1 and 2; the erection rate was 28.9% for group 1, 35.5% for group 2 ( P = 0.1) and 83.3% in group 3 ( P = 0.003), while firm erections were present at 17.7%, 22.2% ( P = 0.2) and 83.3% ( P = 0.002). Women reported equivalent dysfunction in all three groups (15.4%, 20% and 16.6%, P = 0.3). Sexual desire was also equal in all groups (48.2%, 50% and 48.1). Patients in group 1 expressed more bother, while those in group 2 seemed more satisfied by their sexual life (84.4%, 68% and 68.5%, P = 0.04). CONCLUSIONSRadical cystectomy does not affect QoL whichever urinary reconstruction is used, and this implies a determination by the patients to live and adjust to their new conditions. On the contrary, urinary and sexual function are affected and related to the method used to reconstruct the urinary system. KEYWORDSquality of life, bladder cancer, radical cystectomy, ileal conduit, modified S-pouch. OBJECTIVESTo measure the quality-of-life (QoL) outcome and urinary and sexual function and bother after radical cystectomy and different types of urinary tract reconstruction (Bricker vs modified S-pouch neobladder), also assessing differences between them and a normal population. PATIENTS, SUBJECTS AND METHODS

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Modified S‐pouch neobladder vs ileal conduit and a matched control population: a quality‐of‐life survey

et al. 2004

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“…Daytime continence was obtained within, on average, 6.8 ± 16.4 months (9.6 ± 18.7 months for completely continent patients). The interval between each daytime urination was 2.5 ± 0.8 h (median = 2.5 [1][2][3][4][5] …”

Section: Continencementioning

confidence: 99%

“…The orthotopic low pressure detubularised ileal neobladder is the method of choice. This urinary diversion has been presented as providing the best quality of life [1,2]. The quality of life of patients with a neobladder is correlated with their continence and their voiding function.…”

Section: Introductionmentioning

confidence: 99%

The Z‐shaped ileal neobladder after radical cystectomy: an 18 years experience with 329 patients

et al. 2011

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Eighty-three early complications in 80/294 patients (27.2%) occurred. The average Clavian rate of these early complications was 2.24. Among these, 12 complications in 12 patients (4.1%) were pouch-related, and 3 reoperations were required. Two patients died from cardiac complications. Sixty-three late complications in 60/294 patients (20.4%) were recorded. The average Clavian rate of these late complications was 2.98. Among these, 47 complications in 45/294 patients (15.3%) were pouch-related, and 18 reoperations were required, essentially for ureteral anastomosis stricture.Satisfactory daytime urinary continence was achieved in 92% of patients. Daytime continence was obtained within, on average, 6.8 ± 16.4 months. The interval between each daytime urination was 2.6 ± 0.8 h (median = 2.5 [1-5] h). Forty-four (15%) patients developed metabolic acidosis which only required oral medication.Satisfactory nocturnal urinary continence was achieved in 87% of patients. Night-time continence was obtained within, on average, 10.8 ± 22.4 months.Hyper-continence with subsequent need for CISC was observed in 4%. CONCLUSIONIn our series of 329 patients, compared with the other techniques, the Z-shaped ileal neobladder had an 'expected' complication rate for this high risk surgery with satisfactory daytime and night-time continence in nine out of ten patients.

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“…To date, methodology has been limited [7][8][9]13 and results have been mixed. [14][15][16][17][18][19][20] While general health-related quality of life appears to be similar in both, 21 specific issues concerning body image, problematic urine leakage and decreased sexual functioning have been inconsistent, although more commonly reported following ileal conduit diversion. 22 Even so, each type of urinary diversion is associated with a different set of well-described treatment-related effects.…”

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confidence: 99%

Determining when to recommend continent urinary diversion

Gilbert

Montie

2013

CUAJ

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For many bladder cancer patients diagnosed with muscle-invasive disease and in cases of high-risk progressive noninvasive disease, cystectomy is an effective treatment, offering diseasespecific survival of about 87%.1 Bladder cancer survivors, however, face a multitude of health-related consequences following cystectomy. These are mostly related to urinary diversion and reconstruction. While improvements in perioperative care have decreased the surgical morbidity following cystectomy, 2 the complications and functional consequences associated with urinary diversion remain problematic. As a result, the functional and healthrelated quality of life issues following cystectomy are substantial for this group of cancer survivors.The impact of urinary diversion has long been recognized as a major shortcoming of cystectomy and has prompted interest in limiting the adverse functional effects associated with surgical removal of the bladder. Several forms of continent urinary diversion have been developed and refined with the objective of decreasing the burdens associated with diversion. 3,4 In addition, the options and recommended use of continent diversion have expanded during the past decade, and currently, proponents of continent diversion estimate that 80% of men and greater than 65% of women with invasive bladder cancer are candidates for orthotopic continent urinary diversion.5 Most cystectomy patients, however, do not receive continent reconstruction. 6Although the reasons are not entirely clear, significant baseline infirmity and comorbidity, technical complexity, risk of complications 7 and uncertainty regarding a health-related quality of life benefit have likely limited widespread adoption of continent reconstruction.Although the optimal type of urinary reconstruction has not been firmly established, 7-9 continent diversion offers potential advantages through maintenance of anatomic voiding, approximation of normal functional voiding and preservation of preoperative body image. Previous work has shown that complications following this type of diversion are modifiable and that cancer control and survival are independent of the type of urinary diversion used.3,10,11 Experienced groups have reported improvement in short-and long-term complications 3 as well as satisfactory urinary continence in up to 95% of patients following continent urinary diversion.12 While these results are likely not generalizable and may overestimate the health-related quality of life benefit of continent orthotopic urinary diversion, they do underscore the potential benefit of continent diversion when used in the right setting.Still, comparisons of functional outcomes and health-related quality of life in bladder cancer survivors managed with continent and incontinent urinary diversion have been difficult to interpret. To date, methodology has been limited [7][8][9]13 and results have been mixed.14-20 While general health-related quality of life appears to be similar in both, 21 specific issues concerning body image, problematic urine lea...

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Health-Related quality of life with orthotopic neobladder versus ileal conduit according to the SF-36 survey

Cited by 76 publications

References 13 publications

Modified S‐pouch neobladder vs ileal conduit and a matched control population: a quality‐of‐life survey

Modified S‐pouch neobladder vs ileal conduit and a matched control population: a quality‐of‐life survey

The Z‐shaped ileal neobladder after radical cystectomy: an 18 years experience with 329 patients

Determining when to recommend continent urinary diversion

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