Quality of Life After Cystectomy and Urinary Diversion: Results of a Retrospective Interdisciplinary Study

Gerharz, Elmar W.; Weingärtner, K.; Dopatka, Thomas; Köhl, Ulrich; Basler, Heinz-D.; Riedmiller, H.

doi:10.1016/s0022-5347(01)64315-5

Cited by 75 publications

(33 citation statements)

References 28 publications

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“…A similar finding in women was reported by others [3]. [8,9]. Nevertheless, the absence of the collecting device seems to be responsible for the equivalent outcome between groups 2 and 3.…”

Section: Discussionsupporting

confidence: 89%

“…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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“…A similar finding in women was reported by others [3]. [8,9]. Nevertheless, the absence of the collecting device seems to be responsible for the equivalent outcome between groups 2 and 3.…”

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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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“…The even numbers are for anxiety, and the odd numbers for depression. The final score detects light (score 8-10), moderate (score [11][12][13][14] and severe (score 15-21) levels of anxiety or depression.…”

Section: Testsmentioning

confidence: 99%

General State of Health and Psychological Well-Being in Patients after Surgery for Urological Malignant Neoplasms

et al. 2000

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Objective: To evaluate the general state of health and the psychological well-being in a group of 155 patients after surgery for urological malignant neoplasms. Materials and Methods: Surgery was performed in 55 patients for renal cell carcinoma, in 54 for invasive bladder carcinoma, in 30 for adenocarcinoma of the prostate, and in 16 for squamous penile carcinoma. All patients were invited to self-compile the General Health Questionnaire (GHQ) – 12 items according to Goldberg and the Hospital Anxiety and Depression Scale. Results were compared with those in a group of patients who underwent retropubic prostatectomy for benign prostatic hyperplasia. Results and Conclusion: The general state of health was significantly more impaired in neoplastic patients than in the control group. Levels of anxiety were significantly higher but depression levels were similar in both groups. As far as the type of tumor is concerned, patients who underwent radical cystectomy for bladder carcinoma and those treated with partial penectomy for squamous penile carcinoma showed a significant impairment of the general state of health compared with controls. Higher levels of anxiety were observed in patients who underwent ileal conduit after radical cystectomy, in those treated with radical prostatectomy for prostate cancer and in those who underwent partial penectomy. Significantly higher levels of depression than in the control group were observed only in patients with ileal conduit.

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“…The neobladder has replaced ileal conduit as the standard procedure due to better quality of life outcomes, avoidance of stoma, an improved body image and no additional morbidity (11,12). In addition, neobladder reconstruction does not compromise the cancer control.…”

Section: Commentsmentioning

confidence: 99%

Orthotopic ileal neobladder reconstruction for bladder cancer: is adjuvant chemotherapy safe?

et al. 2006

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Objective: We examined our database of patients undergoing radical cystectomy (RC) with orthotopic neobladder (NB) to determine whether adjuvant chemotherapy in this group is safe. Materials and Methods:We performed a retrospective analysis of patients who underwent radical cystectomy and urinary diversion between 1992 and 2004. Relevant clinical and therapeutic data were entered into a database. High-risk bladder cancer patients who underwent NB were identified. They were stratified into 2 groups, those who received adjuvant chemotherapy and those who did not. The incidence of complications between the 2 groups was analyzed and compared. Results: Over the 12-year period, 136 patients underwent RC and NB construction for bladder cancer. Of these, 83 patients were at high risk for recurrence. Nineteen patients received adjuvant chemotherapy and 64 did not. The complication rate in the adjuvant chemotherapy group was 53% and it was 23% in those who did not receive chemotherapy. There were no perioperative or treatment related death. There were 2 patients with grade 4 toxicity in the adjuvant chemotherapy group. There was a statistical difference between these two groups with regard to the incidence of complications. However, none of these complications was life-threatening, required only conservative treatment and caused no long-term disability. Conclusions: Adjuvant chemotherapy is a safe treatment for patients undergoing RC and NB substitution. Hence, the option of orthotopic NB should not be denied in selected bladder cancer patients with high risk for recurrent disease.

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Quality of Life After Cystectomy and Urinary Diversion: Results of a Retrospective Interdisciplinary Study

Cited by 75 publications

References 28 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

General State of Health and Psychological Well-Being in Patients after Surgery for Urological Malignant Neoplasms

Orthotopic ileal neobladder reconstruction for bladder cancer: is adjuvant chemotherapy safe?

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