title: Prospective study of the impact on quality of life of cystectomy with ileal conduit urinary diversion for neurogenic bladder dysfunction.
abstract: OBJECTIVE
  Neurogenic bladder dysfunction has a negative impact on the patient's quality of life (QoL). Cystectomy with ileal conduit urinary diversion is a treatment option in patients in failure after conservative management. The objective of this study was to evaluate the impact of ileal conduit urinary diversion on the QoL of patients with neurogenic bladder dysfunction.
  
  
  METHODS
  From March 2004 to November 2010, 48 patients (36 women and 12 men with a mean age of 50.6  ±  11.8 years) treated by cystectomy with ileal conduit urinary diversion for neurogenic bladder dysfunction, prospectively completed, before and after surgery, two self-administered QoL questionnaires. Neurological diseases were multiple sclerosis in 38 cases, spinal cord injury in 7 cases, and other neurological disease in 3 cases. Cystectomy was performed by laparoscopy in all patients. QoL was measured by using two self-administered questionnaires, one questionnaire specific for urinary disorders validated in neurological patients, Qualiveen®, and the generic SF36-v2® questionnaire. Data were compared by Student's t test.
  
  
  RESULTS
  Comparison of the Qualiveen® self-administered questionnaire scores and indices before and after surgery showed that, after surgery, patients presented a significant reduction of limitations (0.57 ± 0.64 vs. 1.55 ± 1.35, P < 0.001), constraints (2.12  ±  0.83 vs. 2.64  ±  1.12, P = 0.046) scores and the SIUP index (1.29 ± 0.65 vs. 1.79 ± 0.95, P = 0.015). No significant change in SF36-v2® scores was observed postoperatively.
  
  
  CONCLUSIONS
  Ileal conduit urinary diversion improves the urinary QoL of patients with neurogenic bladder dysfunction by decreasing limitations and constraints induced by urinary disorders, but has no impact on general QoL.
authors.affiliation: Service d'Urologie, d'Andrologie et de Transplantation Rénale, CHU Rangueil, Toulouse, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Guillotreau
authors.forename: Evelyne
authors.initials: E
authors.lastname: Castel-Lacanal
authors.forename: Mathieu
authors.initials: M
authors.lastname: Roumiguié
authors.forename: Benoit
authors.initials: B
authors.lastname: Bordier
authors.forename: Nicolas
authors.initials: N
authors.lastname: Doumerc
authors.forename: Xavier
authors.initials: X
authors.lastname: De Boissezon
authors.forename: Bernard
authors.initials: B
authors.lastname: Malavaud
authors.forename: Philippe
authors.initials: P
authors.lastname: Marque
authors.forename: Pascal
authors.initials: P
authors.lastname: Rischmann
authors.forename: Xavier
authors.initials: X
authors.lastname: Gamé
mesh_terms: D000328:Adult; D015653:Cystectomy / Q000009:adverse effects; D005260:Female; D005602:France; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects