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

Nuijens, Siberyn T.; Cobussen-Boekhorst, Hanny; Heesakkers, John; Witjes, J. Alfred

doi:10.1097/mou.0000000000000906

Cited by 2 publications

(2 citation statements)

References 46 publications

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“…Recent studies favor the orthotopic neobladder given the various benefits, including physical and social functioning as well as self-image. However, other factors such as age, gender, comorbidities, and postoperative sexual function might play a more important role than the type of urinary diversion in patient's satisfaction following surgery [38]. In a recent multicenter study of patients who underwent ileal orthotopic neobladder following RC, sexual dysfunction was the only independent factor associated with poorer QOL [68].…”

Section: Quality Of Lifementioning

confidence: 99%

“…Patients in general have great daytime continence and less than 15% of patients experience incontinence. However, nighttime incontinence is more common and up to 70% of patients may wear protection at night [5,38]. Continence improves gradually after surgery as a result of an increase in the reservoir capacity as well as pelvic floor rehabilitation [27].…”

Section: Key Pointsmentioning

confidence: 99%

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Comparative performance of the different orthotopic urinary diversions

Moghaddam

Ghoreifi

Djaladat

2022

Current Opinion in Urology

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Purpose of reviewMajority of patients undergoing radical cystectomy are suitable for orthotopic urinary diversion. The effect of different techniques of neobladder reconstruction on early and long-term postoperative complications is still being determined. Additionally, it is unclear which type of neobladder provides the best patient satisfaction. The purpose of this article is to review the outcomes of different orthotopic urinary diversions following radical cystectomy.Recent findingsIleal neobladder is the preferred type of orthotopic urinary diversion following radical cystectomy. Hautmann and Studer, which are the most common orthotopic diversion techniques, provide daytime continence rate up to 87% and 92%, respectively. However, nighttime continence is achieved in about 50% of patients. High-level evidence supports the long-term safety of orthotopic neobladder in terms of renal function, even in patients with a glomerular filtration rate <60 ml/min. Sexual dysfunction is the only independent factor associated with poorer quality of life in these patients.SummaryThe best type of neobladder is still uncertain. However, Studer and Hautmann are the most commonly performed techniques that provide favorable short- and long-term outcomes.

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Section: Quality Of Lifementioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

Comparative performance of the different orthotopic urinary diversions

Moghaddam

Ghoreifi

Djaladat

2022

Current Opinion in Urology

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Getting specific: participation preference in urooncological decision-making

Büdenbender

Köther

Kriegmair

et al. 2023

BMC Med Inform Decis Mak

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Background Shared decision-making is the gold standard for good clinical practice, and thus, psychometric instruments have been established to assess patients’ generic preference for participation (e.g., the Autonomy Preference Index, API). However, patients’ preferences may vary depending on the specific disease and with respect to the specific decision context. With a modified preference index (API-Uro), we assessed patients’ specific participation preference in preference-sensitive decisions pertaining to urological cancer treatments and compared this with their generic participation preference. Methods In Study 1, we recruited (N = 469) urological outpatients (43.1% urooncological) at a large university hospital. Participation preference was assessed with generic measures (API and API case vignettes) and with the disease-specific API-Uro (urooncological case vignettes describing medical decisions of variable difficulty). A polychoric exploratory factor analysis was used to establish factorial validity and reduce items. In Study 2, we collected data from N = 204 bladder cancer patients in a multicenter study to validate the factorial structure with confirmatory factor analysis. Differences between the participation preference for different decision contexts were analyzed. Results Study 1: Scores on the specific urooncological case vignettes (API-Uro) correlated with the generic measure (r = .44) but also provided incremental information. Among the disease-specific vignettes of the API-Uro, there were two factors with good internal consistency (α ≥ .8): treatment versus diagnostic decisions. Patients desired more participation for treatment decisions (77.8%) than for diagnostic decisions (22%), χ2(1) = 245.1, p ≤ .001. Study 2: Replicated the correlation of the API-Uro with the API (r = .39) and its factorial structure (SRMR = .08; CFI = .974). Bladder cancer patients also desired more participation for treatment decisions (57.4%) than for diagnostic decisions (13.3%), χ²(1) =84, p ≤ .001. Conclusions The desire to participate varies between treatment versus diagnostic decisions among urological patients. This underscores the importance of assessing participation preference for specific contexts. Overall, the new API-Uro has good psychometric properties and is well suited to assess patients’ preferences. In routine care, measures of participation preference for specific decision contexts may provide incremental, allowing clinicians to better address their patients’ individual needs.

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

Cited by 2 publications

References 46 publications

Comparative performance of the different orthotopic urinary diversions

Comparative performance of the different orthotopic urinary diversions

Getting specific: participation preference in urooncological decision-making

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