Orthotopic neobladder versus XXXX after cystectomy--a quality-of-life based comparison.

@entity1 @entity150 @entity1494
INTRODUCTION: Radical cystectomy remains the gold standard in treatment of muscle invasive @entity150 . Evolution of pathological guidelines has empowered centres to offer orthotopic substitution (OBS) to @entity1 undergoing radical cystectomy. We compared health-related quality of life (HRQoL) between @entity1 who underwent OBS or @entity1494 ( @entity1494 ) following radical cystectomy. @entity1 AND METHODS: A total of 57 @entity1 who underwent cystectomy were assessed pre-operatively using Karnofsky performance scale (KPS). Of these, 52 @entity1 (28 OBS and 24 @entity1494 ) who responded to a postal questionnaire consisting of SF-36 and a functional index questionnaire were included. RESULTS: Median age of @entity1 was 70 years. Pre-operative KPS scores were similar. All eight HRQoL scales were favourable in both groups. OBS @entity1 had significantly better physical functioning. In the cohort, 42% of @entity1 with OBS and 25% of diversions could maintain an erection to varying degrees. Of the OBS @entity1 , 85% were continent with two @entity1 reporting reduced QoL with pad usage. Of @entity1494 @entity1 , 63% felt less complete and 42% were embarrassed due to the stoma, with 58% apprehensive of stomal leakage. Of OBS @entity1 , 96% had significant relationships and a more active life-style. CONCLUSIONS: In a similar age-group population, there was no significant difference in most QoL indices but body image issues persist in @entity1494 @entity1 . OBS @entity1 had significantly better physical function, continuing to have a more active lifestyle. They attained urethral voiding with good continence. A detailed discussion of long-term functional outcome would engender a realistic expectation allowing better adaptation.
