title: Assessment of long-term quality of life using the FACT-BL questionnaire in patients with an ileal conduit, continent reservoir, or orthotopic neobladder.
abstract: OBJECTIVE
  To assess and compare quality of life (QOL) of patients followed for a long time who underwent an ileal conduit (IC), continent reservoir (CR) or ileal neobladder (NB) using FACT-BL, a bladder-cancer-specific questionnaire.
  
  
  METHODS
  One hundred and forty-seven patients underwent radical cystectomy and urinary diversion for bladder cancer from 1987 to 2002 at our institution. Of them, 79 (54%) patients were asked to participate in this study. Forty-nine patients (20 IC, 14 CR and 15 NB) returned the answered questionnaire for a survey response rate of 62%. Mean follow-up was 83.0 months.
  
  
  RESULTS
  Four categories (physical, social/familial, emotional and functional well-being) in FACT-G were equally favorable in these groups. Patients with IC had less trouble controlling urine but had a worse image on altered body appearance compared with NB patients. Interest in sex was extremely low in all patients and capability of maintaining an erection was also low in 39 male patients. The mean total value of FACT-BL in IC, CR and NB patients was 106.3+/-16.4, 104.0+/-14.2, and 110.9+/-18.0, respectively, showing no significant difference. Ten (77%) of 13 IC, seven (78%) of nine CR and six (86%) of seven NB patients answered that they would choose the same type of diversion if they had the choice again.
  
  
  CONCLUSIONS
  The type of urinary diversion does not appear to be associated with a different QOL by general cancer-related assessment. Urinary function and body image are affected and related to the method used to reconstruct the urinary system.
authors.affiliation: Department of Urology, Keio University School of Medicine, Shinjuku-ku, Tokyo 160-8582, Japan. eiji-k@kb3.so-net.ne.jp
authors.forename: Eiji
authors.initials: E
authors.lastname: Kikuchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Horiguchi
authors.forename: Jun
authors.initials: J
authors.lastname: Nakashima
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohigashi
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Oya
authors.forename: Ken
authors.initials: K
authors.lastname: Nakagawa
authors.forename: Akira
authors.initials: A
authors.lastname: Miyajima
authors.forename: Masaru
authors.initials: M
authors.lastname: Murai
mesh_terms: D000368:Aged; D001828:Body Image; D015653:Cystectomy / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D019529:Sexuality; D011795:Surveys and Questionnaires; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology / Q000601:surgery; D014547:Urinary Diversion / Q000523:psychology*; D016476:Urinary Reservoirs, Continent