Working capacity and well-being after radical cystectomy with continent cutaneous diversion.
OBJECTIVE
The primary aim was to compare the working capacity in patients with continent urinary diversion with a control group. Secondary aims were to assess the changes in electrolyte and acid-base homeostasis and the functional status during strenuous physical activity, and finally, the well-being in the two groups.


METHODS
Eleven patients who had undergone radical cystectomy and continent cutaneous diversion using an ileocolonic segment participated. The control group consisted of 12 men, matched for age and activity level. Working capacity was assessed by ergospirometry on an exercise bicycle. Venous blood samples were taken before the test, when the expiratory exchange ratio (RER) was about 1.0 and immediately after completion of the test. SF-36 was used to evaluate the subject's functional status and well-being.


RESULTS
The median working capacity in the patient group was 155 (85-190) W and 155 (125-215) W in the control group (n.s.) corresponding to 72 (43-97) % and 80 (59-97) % respectively of predicted values. Peak oxygen uptake was somewhat low in both groups when compared to P-O Astrands norms. Blood tests revealed that patients developed a slight metabolic hyperchloremic acidosis, not seen in the control group. There were no differences between the groups as assessed with SF-36.


CONCLUSIONS
Patients with a continent urinary diversion have a working capacity equal to a control group despite a slight metabolic hyperchloremic acidosis. Quality of life was similar in the two groups and corresponded well with the norms for the general Swedish population aged 65 to 74.
Ohrström
Margareta
M
Department of Health Sciences, Division of Physiotherapy, Lund University Hospital, S-221 85 Lund, Sweden. Margareta.Ohrstrom@med.lu.se
Davidsson
Thomas
T
Månsson
Wiking
W
Wohlfart
Björn
B
Ekelund
Mats
M
D000136:Acid-Base Equilibrium; D000368:Aged; D016022:Case-Control Studies; D015653:Cystectomy; D005080:Exercise Test; D006305:Health Status Indicators; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D005082:Physical Exertion / Q000502:physiology*; D011788:Quality of Life; D013147:Spirometry; D018709:Statistics, Nonparametric; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology / Q000601:surgery*; D014547:Urinary Diversion; D016476:Urinary Reservoirs, Continent