Quality of life in patients after cystectomy as the main aim while making a choice for the urine derivation procedure

Abstract

Objective. To estimate a quality of life (QL) in the patients after radical cystectomy, depending upon the urine derivation method. Materials and methods. Clinical analysis and estimation of QL was conducted in 76 patients, to whom radical cystectomy was performed (the main group). For the urine derivation after radical cystectomy the orthotopic reconstruction of the bladder in accordance to Schtruder’s procedure was accomplished in 26 (34.2%) patients, while Brikker’s ileoplasty – in 50 (65.8%) patients. With the aim for objectivization and standardization of the QL estimation procedure after reconstructive operative intervention on the lower urinary ways in 1 and 12 mo a social-clinical method of the investigation, basing on questionnaire «Medical Outcomes Study – Short Form» (SF-36), was applied. Sexual function was estimated, using questionnaire IIEF-5 (International Index of Erectile Function). Results. Socio-clinical investigations of QL have revealed the best indices in 12 mo in the patients, to whom orthotopic reconstruction of the bladder in accordance to Schtuder’s procedure was done, what differs from the Brikker’s ileoplasty procedure, concerning social functioning, psychological health and vital activity on 18.1, 12.5 and 25% accordingly. All the QL indices in the groups investigated have improved in 12 mo postoperatively, what witnesses about progressing social rehabilitation, not depending upon the kind of the urine derivation. The method of the urine derivation do not influences erectile function, and the main significance is gaining the preservation of nervous and vascular elements of a small pelvis. Conclusion. The results obtained witnesses, that in a psychological way the patients, having a newcyst and with a continent derivation of the urine are accepting their state as a more physiological one. This makes possible the conduction of maximal socio-clinical rehabilitation and adaptation of the able-bodied contingent of patients.

Keywords

• radical cystectomy; artificial bladder; quality of life.