Health related quality of life after radical cystectomy in women: orthotopic neobladder versus ileal loop conduit and impact of incontinence.
BACKGROUND
Enough data about health related quality of life (HRQOL) after radical cystectomy (RC) and urinary diversion (UD) in women is still lacking. The objectives are to evaluate HRQOL in women after RC and orthotopic neobladder (ONB) versus ileal loop conduit (IC) and to assess the impact of urinary continence.


METHODS
The study included 145 women who underwent RC and came for routine follow-up. HRQOL was assessed by two questionnaires (EORTC-QLQ-C30and FACT-Bl). ONB group was stratified to: totally continent, with nocturnal incontinence (NI) and patients in chronic urinary retention (CUR) and maintained on CIC. The orthotopic group (as a whole and its 3 subgroups) was compared to IC.


RESULTS
ONB group included 22 continent women, 35 with NI and 27 in CUR and on CIC. There were no statistically significant differences between ONB and IC groups in all domains of the two questionnaires. However, continent women showed statistically significant better most of EORTC-QLQ-C30 scales and emotional well-being, functional well-being, bladder cancer subscale and FACT-Bl total Score (P˂0.05) than IC group. Similarly, women in CUR showed statistically significant better global health and physical functioning EORTC-QLQ-C30 scores (P values=0.0001, 0.01) and all domains of FACT-Bl. On the other hand, women with NI showed statistically significant lower values in all domains of the EORTC-QLQ-C30 and FACT-Bl than IC group.


CONCLUSIONS
In women, HRQOL is better after ONB than IC as long as continence status is preserved. If incontinence is expected, IC may be a better option for UD.
Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt - zahranmha@yahoo.com.
Mohamed H
MH
Zahran
Urology Department, Kafr El-Sheikh University, Kafr El-Sheikh, Egypt.
Diaa-Eddin
DE
Taha
Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Ahmed M
AM
Harraz
Mental Health Department, Faculty of Education, Mansoura University, Mansoura, Egypt.
Essam M
EM
Zidan
Mental Health Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt.
Mona A
MA
El-Bilsha
Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Mohamed
M
Tharwat
Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Ahmed S
AS
El Hefnawy
Urology Department, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt.
Bedeir
B
Ali-El-Dein
D015653:Cystectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D053206:Nocturnal Enuresis / Q000503:physiopathology*; D011788:Quality of Life; D016896:Treatment Outcome; D014547:Urinary Diversion / Q000009:adverse effects / Q000379:methods; D016055:Urinary Retention / Q000503:physiopathology