The type of urinary diversion after radical cystectomy significantly impacts on the patient's quality of life.
BACKGROUND
In this study, we used a previously well-validated survey to assess the impact of different forms of urinary diversion on overall quality of life in patients with bladder cancer.


METHODS
A total of 92 patients, having three different forms of urinary diversion after radical cystectomy, completed by mail the SF-36, a validated quality-of-life survey. All patients had local/regional disease at the time of cystectomy and are currently without evidence of disease. Completed surveys were then analyzed into physical (PCS) and mental (MCS) component quality-of-life scores per published protocols. Results were then compared with published age-based norms.


RESULTS
A total of 38 men who had cystectomy and ileal neobladder had a mean PCS (+/- SD) of 48.4 (7.8) and a mean MCS of 51.0 (7.4); 16 men and women who had cystectomy and Indiana Pouch had a mean PCS of 48.4 (8.9) and a mean MCS of 55.7 (3.8). None of these results is statistically different from published age- and sex-based population norms. Thirty-eight men who had cystectomy and ileal conduit had a mean PCS of 41.4 (8.5) and a mean MCS of 48.2 (10.7). The PCS is not statistically different from the population-based norm; however, the MCS is significantly decreased from the published norm (P = .01).


CONCLUSIONS
Patients with ileal conduits have significantly decreased mental health quality of life whereas patients with continent urinary diversions do not. Therefore, when not medically contraindicated, patients should be offered a continent diversion as the diversion of choice after cystectomy.
McGuire
M S
MS
Department of Surgery, Evanston Northwestern Healthcare, Illinois, USA. mcmcguire@nwu.edu
Grimaldi
G
G
Grotas
J
J
Russo
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D016737:Proctocolectomy, Restorative / Q000523:psychology; D011788:Quality of Life; D014547:Urinary Diversion / Q000145:classification / Q000379:methods / Q000523:psychology*