title: Does intubated uretero-ureterocutaneostomy provide better health-related quality of life than orthotopic neobladder in patients after radical cystectomy for invasive bladder cancer?
abstract: OBJECTIVE
  Ileal orthotopic neobladder (ONB) has not proved to provide better health-related quality of life (HRQoL) than other urinary diversion techniques after radical cystectomy. The aim of the study is to compare HRQoL assessed by four questionnaires between ONB and uretero-ureterocutaneostomy (UUC).
  
  
  METHODS
  Thirty-nine patients (35 men and 4 women) aged 66.95 ± 8.18 years old underwent radical cystectomy due to invasive bladder cancer and urinary diversion. Patients randomized to ileal ONB and UUC groups, except if certain limitations did not allow performing an ONB. Patients were interviewed face-to-face 7-84 months (median 17) after the operation and completed the Functional Assessment of Cancer Therapy Scale-General (FACT-G), the FACT Vanderbilt Cancer Index (FACT-VCI), the Beck Depression Index (BDI), and the generic RAND 36-item Health Survey Short Form (SF)-36 questionnaire, to asses HRQoL.
  
  
  RESULTS
  Comparing the two groups there were no statistically significant differences for the scores of FACT-G, FACT-VCI, and BDI. For VCI score there was a borderline nonsignificant difference (P = 0.051). No statistically significant differences were noticed also from the comparison of SF-36 subgroups for the two groups except SF. Role emotional subgroup on behalf of UUC (P = 0.022).
  
  
  CONCLUSIONS
  Patients with UUC surprisingly presented at least equal quality of life than the presumably less debilitating and more recent ONB. This could be explained due to lower complication rate and to lower expectations of the UUC group. UUC is a considerable option for urinary diversion after radical cystectomy in the era of HRQoL for selected patients.
authors.affiliation: A' Urologic Department of Aristotelian University of Thessaloniki in G. Gennimatas General Hospital of Thessaloniki, 81A Egnatia Str, 54635 Thessaloniki, Greece. vakalj@otenet.gr
authors.forename: Ioannis
authors.initials: I
authors.lastname: Vakalopoulos
authors.forename: Georgios
authors.initials: G
authors.lastname: Dimitriadis
authors.forename: Anastasios
authors.initials: A
authors.lastname: Anastasiadis
authors.forename: Georgios
authors.initials: G
authors.lastname: Gkotsos
authors.forename: Demetrios
authors.initials: D
authors.lastname: Radopoulos
mesh_terms: D000368:Aged; D015653:Cystectomy / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011788:Quality of Life / Q000523:psychology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014519:Ureterostomy / Q000379:methods* / Q000523:psychology*; D001749:Urinary Bladder Neoplasms / Q000473:pathology* / Q000601:surgery*; D016476:Urinary Reservoirs, Continent