The quality of life in patients with bladder cancer after cystectomy

A survey carried out by means of questionnaires was conducted to assess the impact of different forms of urinary diversion on the quality of life (QOL) in patients with bladder cancer. First, a QOL survey using self-administered questionnaires was carried out on 330 patients who were followed up for more than 3 months after cystectomy at the Okayama University Hospital and its affiliated hospitals. QOL assessment was performed using EORTC QLQ-C30, supplemented with detailed questionnaires about sexual function, voiding function, continence and patient's satisfaction. Among these 330 patients, 80 had an orthotopic urinary reservoir (OUR), 27 had a continent urinary reservoir (CUR) and 223 had a urostomy. Based on the answes to these questionnaires, there was little difference in the QOL score among the three groups. However, as regards satisfaction with the methods of urinary diversion, patients in the OUR group expressed better satisfaction than those in the other two groups. Second, a survey based on the same questionnaires was performed to assess the changes in the QOL of 57 patients observed prospectively from pre-surgery to one year post-surgery. Two kinds of urinary diversion were compared: 26 patients received OUR and 31 patients received urostomy. In most areas, the QOL returned to the prior level within six months after surgery. However, patients were restricted as regards their sexual function. Concerning voiding condition and continence in the OUR group, the score did not return to the prior level within one year. After one year post-surgery, no difference was recognized with regard to any of the items between the two groups.