Introduction and Objectives
Quality of life (QoL) has been evaluated in patients after radical cystectomy due to invasive urinary bladder carcinoma according to the type of urinary derivation (continent / Bricker/ UCN).
Material and Methods
The research included 82 patients who had been operated at Clinic of Urology, Novi Sad. Questionnaire was answered by 71 of them (all were polled 12 months after operation, or even later). Ratio of male to female patients was 3.47:1. Youngest one was 41 and the oldest 78 years of age. An average age was 63.45 years. The most frequent urine derivation was ureterocutaneostomy according to Bricker – 56.4%; ureterocutaneostomy (UCN) – 19.74%; “vesica ileale” Padovana (VIP) – 15.51%; neovesica orthotopica Hautmann – 5.64%; neovesica orthotopica Studer – 2.82%. Continent bladders were performed in total of 23.97%. Psycho-physical, emotional, social and economic consequences of malignant diseases treatment were investigated by adequate questionnaire. We have used EORTC QLQ-30, standard questionnaire, with two special queries added.
Results
We have noticed that most invasive disease occurred in patients whom UCN has been performed, according to TNM classification and pathological histology analyses. The highest percentage of mortality (30%) during the postoperative period of one year was reported in the group of patient whom UCN has been performed. Patients with continent derivation answered in 35.3% of cases that they had spent most of the day in bed, with Bricker in 32.5%, and those with UCN in 35.7%. In the case of continent derivation only two patients (11.76%) stated that they experienced very limited work abilities and everyday activities, while in the cases of Bricker derivation rate of limitation was 22.5%, and in UCN cases 42.85%. Personal hygiene was easiest to keep in cases of continent derivation and ratio of answers to maximum score was 6.53, Bricker 6.14 and UCN 5.56 of maximum 7 points. Ability to stay out of the house environment, patients with continent derivation scored with 4.97, Bricker 4.16, while UCN patient with 4.21 of maximum 7 points. Better possibilities for sex life has also been noticed in group of patients with continent derivation (score 1.43) and in Bricker patients it was 1.26, of maximum 7 points 1.43. When polled if they had been worried during past week, all compared groups gave approximately the same answer distribution.
Conclusions
The results are significantly affected by the follow-up time (time after operation until polling varied), age, patient's personality, ability to solve problem, ways of upbringing and grade of education. From studied data, it can be concluded that quality of life is higher in patients whom reconstructive operation has been performed. As psychological and social factors in operative techniques choosing has been very important, we hold opinion that patient should be informed about possible advantages and disadvantages of certain type of derivation.
Article info
Identification
Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
