Health-related quality of life after cystectomy: bladder substitution compared with ileal conduit diversion. A questionnaire survey.
OBJECTIVE
To compare the health-related quality of life after bladder substitution with that following ileal conduit diversion.


METHODS
Sixty-seven male patients with bladder cancer completed the questionnaire; 38 had undergone bladder substitution and 29 ileal conduit diversion; the median follow-up was 1.0 year (range 0.5-3.0) and 4.8 years (range 1.1-15.2), respectively. Semi-structured qualitative interviews were conducted and analysed, and the questionnaire was developed based upon these results.


RESULTS
Both day- and night-time urinary leakage occurred more frequently following bladder substitution (18% against 10%, and 21% against 3%). Nevertheless, urinary leakage affected conduit patients more severely and they scored higher on a leakage distress scale. Furthermore, 58% of the ileal conduit but only 21% of the bladder substitution patients gave urinary leakage as their main concern (P = 0.04). Ileal conduit patients did not retain their body image as well as those with bladder substitution. The frequency of both sexual and non-sexual physical contacts decreased in the majority of the conduit patients but only in a minority of the bladder substitute patients. Global satisfaction was high and similar in both groups.


CONCLUSIONS
These results show that the health-related quality of life is retained to a higher degree after bladder substitution and supports the use of this procedure as the standard method of diversion after cystectomy for bladder cancer.
Department of Urology, Herlev Hospital, Denmark.
B D
BD
Bjerre
C
C
Johansen
K
K
Steven
D000368:Aged; D001007:Anxiety / Q000209:etiology; D003142:Communication; D015653:Cystectomy / Q000523:psychology*; D003967:Diarrhea / Q000523:psychology; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D012649:Self Concept; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000523:psychology* / Q000601:surgery; D014547:Urinary Diversion / Q000523:psychology*; D016476:Urinary Reservoirs, Continent / Q000523:psychology; D014555:Urination Disorders / Q000523:psychology