Longitudinal Health Related Quality of Life After Open Radical Cystectomy: Comparison of Ileal Conduit, Indiana Pouch, and Orthotopic Neobladder

Kern, Sean; Speir, Ryan; Tong, Yan; Kaimakliotis, Hristos Z.; Masterson, Timothy A.; Bihrle, Richard; Foster, Richard S.; Koch, Michaël; Cary, Clint

doi:10.1016/j.urology.2020.12.036

Cited by 9 publications

(27 citation statements)

References 13 publications

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“…preferred reporting items for systematic reviews and meta-analyses exhibited a study level "good" quality assessment, [21][22][23][27][28][29][30]32,33,37,[41][42][43] eight (32%) "fair" quality, 20,25,31,35,[38][39][40]44 and four (20%) "unclear" quality, 24,26,34,36 and none of the included studies were found to be of "poor" quality.…”

Section: Risk Of Bias In Studiesmentioning

confidence: 99%

A new stoma for an older person—An association with quality of life and physical function: A systematic review

Neuberger

Braude

Weeks

et al. 2022

J American Geriatrics Society

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Background: Older people are more likely to have a stoma postabdominal surgery than younger people. Few studies have examined the effect of a stoma on older people. The aim of this review was to explore the effect of a stoma on functional independence of an older person. We explored secondary outcomes of poststoma formation length of hospital stay, quality of life and factors affecting stroma independence. Methods: An exploratory systematic review was developed by our multidisciplinary group including an expert patient, colorectal surgeon, stoma nurse, physiotherapist, geriatrician, and methodologist. Four databases were searched including studies with participants 60 years old or older, who had undergone abdominal surgery for any pathology resulting in an abdominal stoma. Results:We identified 857 studies, of which we included 25 in the final review incorporating 6972 participants (average age 67.4 years). There was a strong association between presence of stoma and (1) worse physical function (standardized MD = 0.7; 95% CI 0.21-1.19; I 2 = 95) and (2) worse quality of life (standardized MD = 1.61; 95% CI 0.5-2.72, I 2 = 98). The same effect was seen in fecal ostomy and urinary diversion. Few studies measured stoma independence and only one examined factors affecting this. No studies examined length of stay. Conclusions: Stoma have a negative association with the physical function and quality of life of older people. Future studies should focus on identifying modifiable factors that may affect physical function, quality of life, and stoma independence.

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Section: Risk Of Bias In Studiesmentioning

confidence: 99%

A new stoma for an older person—An association with quality of life and physical function: A systematic review

Neuberger

Braude

Weeks

et al. 2022

J American Geriatrics Society

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“…Interestingly, in a prospective longitudinal study on 146 patients with ileal conduit, ONB or Indiana pouch by Kern et al [12 ▪ ], similar improvements in HRQOL across all diversion cohorts were found, even though patients who received an ileal conduit had a higher morbidity index score and a lower baseline HRQOL. This shows that, in these patients, the type of urinary diversion is not necessarily important for their HRQOL status but there are other factors that play a more important role.…”

Section: Orthotopic Neobladder and Ileal Conduitmentioning

confidence: 79%

“…Also, cross-sectional studies only measure HRQOL at one point in time at unequal intervals from the date of operation. As HRQOL after radical cystectomy in ileal conduit and ONB patients gradually increases in the first year postoperative, measuring at unequal intervals can give different results in the same patient [11,12 ▪ ]. Finally, studies comparing outcomes of different urinary diversions are nonrandomized.…”

Section: Orthotopic Neobladder and Ileal Conduitmentioning

confidence: 99%

Patient-reported outcomes and health-related quality of life after urinary diversions

Nuijens

Cobussen-Boekhorst

Heesakkers

et al. 2021

Current Opinion in Urology

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Purpose of reviewTo study the recent literature on health-related quality of life (HRQOL) in patients after radical cystectomy followed by urinary diversion.Recent findingsGeneral consensus regarding, which urinary diversion is superior in terms of HRQOL has not been reached. Although there is an increase in studies favoring the orthotopic neobladder, overall quality of these studies is poor. Other studies suggest that HRQOL outcomes in different types of urinary diversions is similar and that other factors, such as age, comorbidities and sex are more important instead. Patient choice, in consultation with the treating surgeon should be the determinant of which urinary diversion is performed. Furthermore, sexual function can play an important role in HRQOL. However, practice shows that counselling on the option of sexual-preserving techniques is still not implemented in routine clinical practice. Furthermore, studies regarding differences in HRQOL after urinary diversion between male and female individuals are lacking.SummaryThorough preoperative counselling on the different types of urinary diversion and options for sexual-preserving techniques decreases decision regret and increases HRQOL in patients after radical cystectomy.

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“…In our opinion, these results are partially comparable with those reported by us because the Clements study has a follow-up of up to 24 months and because it does not evaluate HRQOL exclusively in women. However, if we analyze the results of Kern, we observe that in the long term and in a perspective way there are no significant differences in HRQOL among non-continent, continent cutaneous, and continent orthotopic urinary diversion groups, which can serve as an important point of consideration during patient counseling ( 2 ).…”

Section: Discussionmentioning

confidence: 99%

“…However, RC is also a recommended treatment for high-risk non muscle-invasive bladder cancer (NMIBC) when non-responsive to standard treatments. In this context, it is well known that RC often deeply affects patients’ life, as this surgery is a traumatic and invasive event for the patients, with drawbacks on their daily, social, working, and sex life ( 2 , 3 ). Such changes and quality of life (QoL) of patients are commonly studied through retrospective clinical evaluations and rarely with longitudinal studies.…”

Section: Introductionmentioning

confidence: 99%

Quality-of-Life Outcomes in Female Patients With Ileal Conduit or Orthotopic Neobladder Urinary Diversion: 6-Month Results of a Multicenter Prospective Study

et al. 2022

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Radical cystectomy (RC) often affects patients’ life as this surgery is a traumatic and invasive event for the patients, with drawbacks on their daily, social, working, and sex life. Such changes in the quality of life (QoL) of patients are commonly studied through retrospective clinical evaluations and rarely with longitudinal studies. To date, studies focusing on functional outcomes, sexual function, and health-related QoL for female patients are lacking. We evaluated 37 patients using EORTC QLQ-C30 (QLQ-30) and Short-Form 36 (SF-36) questionnaires, before and after surgery, at 3 and 6 months of follow-up. The mean values for the emotional functioning in QLQ-C30 as well as the mental health in SF-36 were significantly higher in the ONB group compared to the IC group at 3 months of follow-up. These differences were not significant at 6 months of follow-up. At 6 months of follow-up, the ONB group showed a higher mean score in the physical and role functioning than the IC group. Although there was a statistically significant age difference at baseline of the two groups, none of the results are correlated with age, as demonstrated by Spearman’s analysis. The ONB seems to represent the most advantageous solution compared to the IC in terms of QOL at the 6-month follow-up.

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Longitudinal Health Related Quality of Life After Open Radical Cystectomy: Comparison of Ileal Conduit, Indiana Pouch, and Orthotopic Neobladder

Cited by 9 publications

References 13 publications

A new stoma for an older person—An association with quality of life and physical function: A systematic review

A new stoma for an older person—An association with quality of life and physical function: A systematic review

Patient-reported outcomes and health-related quality of life after urinary diversions

Quality-of-Life Outcomes in Female Patients With Ileal Conduit or Orthotopic Neobladder Urinary Diversion: 6-Month Results of a Multicenter Prospective Study

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