title: Health-related quality of life after radical cystectomy and neobladder reconstruction in women: impact of voiding and continence status.
abstract: OBJECTIVE
  To assess health-related quality of life, and the impact of night-time incontinence and chronic urinary retention on health-related quality of life in women with bladder cancer after radical cystectomy and orthotopic neobladder.
  
  
  METHODS
  The study included 74 women who underwent radical cystectomy and orthotopic neobladder, and completed 1 year of follow up. Health-related quality of life was evaluated using the questionnaires of the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire and the Functional Assessment of Cancer Therapy bladder cancer-specific form. Health-related quality of life was compared with an age-matched control group. The impact of night-time incontinence and chronic urinary retention on health-related quality of life was assessed.
  
  
  RESULTS
  The study group included 18 completely continent patients with spontaneous voiding, 29 with night-time incontinence and 27 with chronic urinary retention. The study group was statistically significantly lower in all domains of health-related quality of life than the control group. In all domains of the European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire and Functional Assessment of Cancer Therapy bladder cancer-specific form, completely continent women were comparable with those with chronic urinary retention. Women with night-time incontinence had a significantly worse health-related quality of life than completely continent women, shown by the mean global health score (P = 0.038), social functioning score (P = 0.012), pain European Organization for Research and Treatment of Cancer-Quality of Life Questionnaire score (P = 0.04), and functional well-being Functional Assessment of Cancer Therapy bladder cancer-specific form (P = 0.049) score.
  
  
  CONCLUSIONS
  After radical cystectomy and orthotopic neobladder in women, health-related quality of life is lower than that of the normal population. Night-time incontinence has a negative impact on social life and most domains of health-related quality of life. Thus, night-time incontinence has a higher social impact than chronic urinary retention.
authors.affiliation: Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
authors.forename: Mohamed H
authors.initials: MH
authors.lastname: Zahran
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: El-Hefnawy
authors.forename: Essam M
authors.initials: EM
authors.lastname: Zidan
authors.forename: Mona A
authors.initials: MA
authors.lastname: El-Bilsha
authors.forename: Diaa-Eldin
authors.initials: DE
authors.lastname: Taha
authors.forename: Bedeir
authors.initials: B
authors.lastname: Ali-El-Dein
mesh_terms: D000328:Adult; D000368:Aged; D015653:Cystectomy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011788:Quality of Life; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion; D014549:Urinary Incontinence / Q000209:etiology*; D016055:Urinary Retention / Q000209:etiology*
keywords: bladder neoplasm; orthotopic diversion; quality of life in women; radical cystectomy