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Health related quality of life (HRQoL) after cystectomy: comparison between orthotopic neobladder and ileal conduit diversion

Health related quality of life (HRQoL) after cystectomy: comparison between orthotopic neobladder and ileal conduit diversion
Health related quality of life (HRQoL) after cystectomy: comparison between orthotopic neobladder and ileal conduit diversion

INTRODUCTION: Radical cystectomy and urinary diversion carries a high morbidity. Quality of life and body image are important considerations for urinary diversion (UD). We wanted to conduct a systematic review of literature to see which form UD offers a better quality of life (QoL).

METHODS: We searched MEDLINE, Pubmed, EMBASE, CINAHL and the Cochrane library for studies using the following key words: 'quality of life' and 'ileal conduit', 'orthotopic neobladder', 'continent diversion' and 'urinary diversion'. All English language articles on UD surgery were included in the original search from 1990 to 2014. To improve the quality of evidence, we stratified our inclusion criteria into studies that report on QoL in both forms of UD using at least one validated questionnaire.

RESULTS: Twenty-one studies (2285 patients) were included in our study all of which used at least one validated tool. The most frequently used tools were the SF-36, EORTC QLQ-C30 and FACT BL (10, 8, 5 studies respectively). None of the studies were randomised and only 4 studies were prospectively designed. Sixteen studies reported no difference in QoL between the two types of urinary diversion and four studies reported a better QoL with orthotopic neobladder of which 2 studies had younger and fitter patients. On the other hand, one study reported a better QoL in ileal conduit patients.

CONCLUSION: Orthotopic neobladder urinary diversion shows a marginally better quality of life scores compared to ileal conduit diversion especially when considering younger and fitter patients.

Carcinoma, Transitional Cell, Cystectomy, Health Status, Humans, Ileum, Quality of Life, Urinary Bladder Neoplasms, Urinary Diversion, Urinary Reservoirs, Continent, Comparative Study, Journal Article, Review
0748-7983
295-299
Ali, A.S.
2febc168-30aa-4e66-a932-7c94464362c3
Hayes, M.C.
5fc8ef86-8177-4305-ada4-4dd85174ec43
Birch, B.
8a94cd36-d429-4ab4-82a6-a376b4d4e10f
Dudderidge, T.
dae51cb9-9192-4352-9d7e-c7b2fcc4031a
Somani, B.K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9
Ali, A.S.
2febc168-30aa-4e66-a932-7c94464362c3
Hayes, M.C.
5fc8ef86-8177-4305-ada4-4dd85174ec43
Birch, B.
8a94cd36-d429-4ab4-82a6-a376b4d4e10f
Dudderidge, T.
dae51cb9-9192-4352-9d7e-c7b2fcc4031a
Somani, B.K.
ab5fd1ce-02df-4b88-b25e-8ece396335d9

Ali, A.S., Hayes, M.C., Birch, B., Dudderidge, T. and Somani, B.K. (2015) Health related quality of life (HRQoL) after cystectomy: comparison between orthotopic neobladder and ileal conduit diversion. European Journal of Surgical Oncology, 41 (3), 295-299. (doi:10.1016/j.ejso.2014.05.006).

Record type: Review

Abstract

INTRODUCTION: Radical cystectomy and urinary diversion carries a high morbidity. Quality of life and body image are important considerations for urinary diversion (UD). We wanted to conduct a systematic review of literature to see which form UD offers a better quality of life (QoL).

METHODS: We searched MEDLINE, Pubmed, EMBASE, CINAHL and the Cochrane library for studies using the following key words: 'quality of life' and 'ileal conduit', 'orthotopic neobladder', 'continent diversion' and 'urinary diversion'. All English language articles on UD surgery were included in the original search from 1990 to 2014. To improve the quality of evidence, we stratified our inclusion criteria into studies that report on QoL in both forms of UD using at least one validated questionnaire.

RESULTS: Twenty-one studies (2285 patients) were included in our study all of which used at least one validated tool. The most frequently used tools were the SF-36, EORTC QLQ-C30 and FACT BL (10, 8, 5 studies respectively). None of the studies were randomised and only 4 studies were prospectively designed. Sixteen studies reported no difference in QoL between the two types of urinary diversion and four studies reported a better QoL with orthotopic neobladder of which 2 studies had younger and fitter patients. On the other hand, one study reported a better QoL in ileal conduit patients.

CONCLUSION: Orthotopic neobladder urinary diversion shows a marginally better quality of life scores compared to ileal conduit diversion especially when considering younger and fitter patients.

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More information

Accepted/In Press date: 15 May 2014
e-pub ahead of print date: 23 May 2014
Published date: March 2015
Additional Information: Copyright © 2014 Elsevier Ltd. All rights reserved.
Keywords: Carcinoma, Transitional Cell, Cystectomy, Health Status, Humans, Ileum, Quality of Life, Urinary Bladder Neoplasms, Urinary Diversion, Urinary Reservoirs, Continent, Comparative Study, Journal Article, Review

Identifiers

Local EPrints ID: 419368
URI: http://eprints.soton.ac.uk/id/eprint/419368
ISSN: 0748-7983
PURE UUID: c27c6e98-78c4-4b84-bd93-3db9bafe0a46

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Date deposited: 11 Apr 2018 16:30
Last modified: 13 Mar 2019 18:44

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Contributors

Author: A.S. Ali
Author: M.C. Hayes
Author: B. Birch
Author: T. Dudderidge
Author: B.K. Somani

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