An evaluation of quality of life in patients with continent urinary diversions after cystectomy

Abstract

Objective To determine the long‐term results and assess the quality of life in patients with continent urinary diversions after cystectomy. Patients and methods Eighty‐six consecutive patients who received a continent urinary diversion from 1988 to 1994 at the Vancouver Hospital and Health Sciences Center were evaluated. The evaluation comprised a review of their hospital charts and clinic visits at 3 months and then yearly. Quality of life issues were assessed using a postal questionnaire pertaining to the patient’s urinary symptoms, activity level and overall well‐being while living with a continent urinary diversion. Two separate questionnaires were sent, addressing heterotopic or orthotopic diversions. Results There was an acceptable rate of complications, with stone formation and urinary tract infection as the most common morbidities. Continence was rated as good in most patients, with no patient reportingcomplete incontinence. Undesirable urinary symptoms occurred less often than 20% of the time in most patients. Although there was a significant effect on sex life, the overall quality of life appeared to be very good, as 70% of the patients had no limitations to their activities. Conclusions The techniques currently evolved for urinary diversion produce good long‐term results and quality of life. These diversions should be considered in a well selected patient population.

Health-Related Quality of Life after 5-12 Years of Continent Ileal Urostomy (Kock Reservoir) in Children and Adolescents

“…In the present series, the operation did not have any bad in uence on our patients concerning their interaction with friends and hobbies. Continent urostomy can be rated as a real alternative in terms of quality of life for patients who require urinary diversion for any reason (1,12,18). In the present series, all patients appreciated the operation and felt free to lead an acceptable life.…”

“…Continent urinary diversion produces good longterm results (12)(13)(14) and, compared with traditional incontinent urostomy, provides a more attractive alternative for patients both from the social and the psychological viewpoint (12). Absence of odor and leakage are important qualities of a reservoir with adequate function, since such problems can give rise to Continent ileal urostomy (Kock reservoir) in children and adolescents isolation, depression, anxiety and limitation of various activities (11).…”

Improving selection of appropriate urinary diversion following radical cystectomy for bladder cancer

“…In two retrospective studies similar results were obtained, except that patients with a conduit reported more problems with their bathing habits [76,77]. None of the three published retrospective studies showed a difference between continent cutaneous diversion compared with orthotopic diversions [78][79][80]. With all instruments, the function of different diversions, expectations and quality of life remains very difficult to assess.…”

Quality of Life after Radical Cystectomy and Diversion

“…Retrospektif yapılmış olan 3 çalışmada yaşam kaliteleri arası fark bulunmamıştır (52,53,54). Weijerman'ın 56 hastada 3 değişik diversiyon tekniği ile yaptığı çalışmada genelde benign hastalığı olan olgular kullanılmış.…”

“…Bunlarda daha çok işeme ve inkontinansa yönelik sorgulama yapılmış ve fark olmadığı saptanmış (54). Sullivan'ın yaptığı 55 hastalık çalışmada sadece 10 hastaya kutaneöz diversiyon uygulanmış ve heriki grupta farklı olmayan ve oldukça iyi yaşam kalitesi bildirilmiştir (53). Mansson'un yaptığı nispeten daha yeni çalışmada FACT-BL ve hastane depresyon skalası kullanılmış ve fark bulunmamıştır (55).…”