title: Long-term women-reported quality of life after radical cystectomy and orthotopic ileal neobladder reconstruction.
abstract: BACKGROUND
  The purpose of this study was to determine health-related quality of life (HRQoL) among long-term disease-free survivors in women who underwent radical cystectomy (RC) for urothelial carcinoma and orthotopic ileal neobladder (ONB) reconstruction, using validated patient-reported outcome instruments.
  
  
  METHODS
  From 2000 to 2011, a total of 46 women with urothelial bladder carcinoma had RC and ONB at our institution; 31 (67 %) eligible women completed 3 validated questionnaires: the medical outcome study short form 12 (SF-12), the urinary symptom profile, and the Contilife, respectively evaluating general HRQoL, voiding function, and urinary incontinence specific HRQoL. Unadjusted analyses were performed to analyze standardized measures of HRQoL and voiding symptoms; p < 0.05 was considered significant.
  
  
  RESULTS
  The mean follow-up was 5.7 years; 24 women (77 %) considered their health as good, very good, or excellent. The SF-12 physical and mental scores were not significantly different between the population study and the general population (p > 0.05). A total of 20 women (65 %) declared to be fully continent. Daytime incontinence, nighttime incontinence, and hypercontinence were reported by 26, 29, and 31 % of women, respectively. On unadjusted analysis, incontinence was associated with age > 65 years at the time of surgery (p < 0.001). Hypercontinence was not associated with any variable.
  
  
  CONCLUSIONS
  This study suggests that in the setting of radical cystectomy in women, ileal neobladder reconstruction provides long-term satisfaction with maintained HRQoL. For properly selected women, orthotopic neobladder can be considered an appropriate diversion choice.
authors.affiliation: Department of Urology, Hôpital Foch, Suresnes, France, rouanne.mathieu@gmail.com.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Rouanne
authors.forename: Guillaume
authors.initials: G
authors.lastname: Legrand
authors.forename: Yann
authors.initials: Y
authors.lastname: Neuzillet
authors.forename: Tarek
authors.initials: T
authors.lastname: Ghoneim
authors.forename: Florence
authors.initials: F
authors.lastname: Cour
authors.forename: Nicolas
authors.initials: N
authors.lastname: Letang
authors.forename: Laurent
authors.initials: L
authors.lastname: Yonneau
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Hervé
authors.forename: Henry
authors.initials: H
authors.lastname: Botto
authors.forename: Thierry
authors.initials: T
authors.lastname: Lebret
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D014547:Urinary Diversion; D014554:Urination / Q000502:physiology