title: Urostomy and health-related quality of life in patients with lower urinary tract dysfunction.
abstract: OBJECTIVE
  Urinary diversion may be an option in patients with disabling lower urinary tract dysfunction (DLUTD), refractory to conservative and minor invasive treatment. The aim of this study was to evaluate whether urostomy improves quality of life and cost of surgery, in terms of complications, loss of kidney function and hospital stay, in these patients.
  
  
  METHODS
  This prospective study included 52 consecutive patients (nine men and 43 women) with various benign disorders. Twenty-six patients received an ileal conduit and 26 a continent cutaneous diversion. The patients completed the general health-related quality of life instrument WHOQOL-BREF and a urinary problem-specific quality of life instrument preoperatively and 6 and 12 months after surgery. Length of hospital stay and complications were registered. Intravenous urography and determination of glomerular filtration rate (GFR) were performed preoperatively and 12 months postoperatively.
  
  
  RESULTS
  Disease-specific and health-related quality of life improved significantly (p < 0.0005 and p < 0.05) in all domains except for social relationship, from preoperative to 12 months after surgery. There was no difference in improvement between patients with continent and those with incontinent diversion. Mean hospital stay was 14 days. Early and late complications required open surgery in 12 patients (23%). GFR was unchanged postoperatively.
  
  
  CONCLUSIONS
  Urinary diversion improves health-related and disease-specific quality of life in patients with DLUTD refractory to conservative and minor invasive treatments. The burden of surgery is acceptable. Urinary diversion could be recommended more often in such patients.
authors.affiliation: Department of Urology, Section of Reconstructive Urology and Neurourology Oslo University Hospital, Rikshospitalet.
authors.forename: Alexander
authors.initials: A
authors.lastname: Schultz
authors.forename: Birgitte
authors.initials: B
authors.lastname: Boye
authors.forename: Olof
authors.initials: O
authors.lastname: Jonsson
authors.forename: Peter
authors.initials: P
authors.lastname: Thind
authors.forename: Wiking
authors.initials: W
authors.lastname: Månsson
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018856:Cystitis, Interstitial / Q000601:surgery*; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D053201:Urinary Bladder, Overactive / Q000601:surgery*; D014547:Urinary Diversion; D016476:Urinary Reservoirs, Continent
keywords: neurological disease; quality of life; urinary diversion; urological problems