A pilot study of the assessment of the quality of life, functional results, and complications in patients with an ileal neobladder for invasive bladder cancer

Abstract

Objective: To assess the functional results, health-related quality of life (QOL) outcomes, and complications in patients with an ileal neobladder in comparison to those with cutaneous diversion (ileal conduit and cutaneostomy). Methods: Between September 1992 and February 2003, we consecutively performed an ileal neobladder (the Studer method) in 30 patients and cutaneous diversion in 38 patients. In August 2004, questionnaires were mailed to 54 patients. The questionnaire included the validated health-related quality of life (QOL) questionnaire, SF-36 General Health Survey, and a urinary incontinence questionnaire. We also evaluated the functional results in patients with an ileal neobladder and the postoperative complications in patients with both urinary diversions. Results: The data from 41 patients (21 ileal neobladder procedures and 20 cutaneous diversions) were available for the analysis. No differences in the overall QOL were observed between the two groups. Complete daytime and night-time urinary continence was achieved in the 21 patients (100%) and 13 patients (61.9%), respectively. The mean value of the maximum flow rate was 15 Ϯ 12 mL/min in the 21 neobladder patients. There were 19 early complications in 18 patients (60.0%) and seven late complications in six patients (20.0%) with an ileal neobladder. However, there were 15 early complications in 14 patients (36.8%) and eight late complications in six patients (15.8%) with cutaneous diversions. Conclusion:The findings regarding the health-related QOL and the frequency of complications in the neobladder group and those in the cutaneous diversion group were similar. However, the functional results and the status of urinary continence in the neobladder patients were satisfactory.

Assessment of long-term quality of life in patients with orthotopic neobladder followed for more than 5 years

“…Previously, a few groups have discussed the issue of health-related QOL comparing orthotopic neobladder with other types of urinary diversion, that is, ileal conduit or continent urinary reservoir [3,4,15]. However, long-term effects on QOL in these patients have scarcely been reported.…”

“…Recently, several groups analyzed QOL after the reconstruction of neobladder to clarify the effects on physical, social and mental status [2][3][4]. Most papers show that overall QOL remains good in most patients and that there are few differences among diversions.…”

Health-related quality of life after hand-assisted laparoscopic and open radical nephrectomies of renal cell carcinoma

“…As an important HRQOL evaluation tool, SF-36 has been widely used to compare patients with urinary system cancers. For example, HRQOL in bladder cancer [11], prostate cancer [12], etc. can be accessed by using the SF-36.…”

Orthotopic bladder substitution: Surgical aspects and optimization of outcomes

“…Overall QoL remains good in most patients with OBS, with few differences between different types of diversion 3,82,83,84 . Health‐related quality of life (HRQoL) tested by the Short Form‐36 and a functional index questionnaire comparing orthotopic substitution with ileal conduit after radical cystectomy were favorable in both groups after a median follow‐up of 12‐15 months 59 .…”

“…Overall QoL remains good in most patients with OBS, with few differences between different types of diversion. 3 , 82 , 83 , 84 Health‐related quality of life (HRQoL) tested by the Short Form‐36 and a functional index questionnaire comparing orthotopic substitution with ileal conduit after radical cystectomy were favorable in both groups after a median follow‐up of 12‐15 months. 59 While OBS patients had overall higher (favorable) mean scores for most parameters, there was no significant difference in most QoL indices, but issues with regards to body image were persistent in a patient with ileal conduit diversion.…”