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Kim SH, Ryu E, Jeong BC. Role performance and factors affecting quality of life in bladder cancer survivors with ileal orthotopic neobladder. Asia Pac J Oncol Nurs 2024; 11:100490. [PMID: 38827560 PMCID: PMC11141134 DOI: 10.1016/j.apjon.2024.100490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/15/2024] [Indexed: 06/04/2024] Open
Abstract
Objective Bladder cancer survivors with neobladder experience changes in role performance and quality of life (QoL) due to various symptoms and problems, but related studies are limited. Therefore, this study attempted to explore the QoL and factors influencing it in bladder cancer survivors with neobladder. Methods A cross-sectional descriptive design was used. Data were collected from 100 bladder cancer survivors with a neobladder using the European Organisation for Research and Treatment of Cancer QLQ-C30 and Muscle-Invasive Bladder Cancer Module, the Patient Activation Measure 13, the Enforced Social Dependency Scale, and the Multidimensional Scale of Perceived Social Support. Factors affecting the QoL were identified using multiple regression analysis. Results QoL significantly differed by daily pad usage, need for clean intermittent catheterization, and role performance. QoL was correlated with urinary symptoms and problems, future perspective, abdominal bloating and flatulence, body image, role performance, and social support. Role performance, body image, and the need for clean intermittent catheterization were identified as the factors affecting QoL. Conclusions The study highlights the importance of bladder cancer survivors continuing their roles at home, at work, and in society after neobladder reconstruction. Specifically, continuing recreational and social activity positively affects QoL, even if the activity range is modified. To help with their role performance, institutional support and changes in social perception are needed. Additionally, education and interventions, including body image enhancement, symptom management, and self-care, should be developed and applied to improve their QoL.
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Affiliation(s)
- So Hee Kim
- Department of Nursing, Korean Bible University, Seoul, Republic of Korea
| | - Eunjung Ryu
- Department of Nursing, Chung–Ang University, Seoul, Republic of Korea
| | - Byong Chang Jeong
- Department of Urology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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Salihagic IK, Hrkac A, Ovcaricek S, Bokarica P, Gilja I. Outcome of small versus big capacity Hautmann neobladder reconstruction: A prospective randomized study - a 5-year follow up. Technol Health Care 2024; 32:951-962. [PMID: 37661899 DOI: 10.3233/thc-230339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Abstract
BACKGROUND Orthotopic urinary diversion is the preferred diversion after cystectomy. Neobladder reconstruction with a longer ileum segment (60 cm) is advantageous for obtaining a large capacity and continence at the beginning; however, the long-term risk of residual urine, chronic infection, and the need for intermittent catheterization is more pronounced with the neobladder constructed with a longer ileal segment compared to the neobladder tailored from the shorter ileal segment. OBJECTIVE To establish the differences in the functional outcome of a shorter (< 45 cm) and longer (⩾ 45 cm) ileal segment usage in the reconstruction of the Hautmann ileal neobladder following the radical cystectomy. METHODS Between July 2013 and September 2015, 121 patients with muscle-invasive bladder cancer underwent radical cystectomy and Hautmann ileal neobladder reconstruction. Patients were divided into two groups, depending on the length of the ileum used for the diversion creation: < 45 cm of the ileum was used in the first group and ⩾ 45 cm in the second group. Five-year follow-up was performed at 1, 3, 6, and 9 months and 1 and 5 years. The main measured outcomes were functional outcomes and the quality of life. The evaluation included clinical, laboratory, and QLQ-C30 questionnaires. Statistical analysis was performed using descriptive statistics, Mann-Whitney U test, Kolmogorov-Smirnov test, ANOVA, and chi-squared tests. RESULTS Patients with a smaller neobladder had a better quality of life, and higher global health status scale score. Thirteen early and 21 late complications developed in 10 and 17 patients, respectively. There were significant differences in the need for clean intermittent self-catheterization (CIC) between the two groups: smaller-volume pouch patients had statistically decreased need for CIC in 5 year follow-up compared to larger-volume pouch patients (χ2 test = 8.245; df = 1; P= 0.004). Eighteen percent of patients with smaller neobladders had urinary tract infections in 5 years, compared to 35% with larger neobladders (χ2 test = 4.447; df = 1; P= 0.034). CONCLUSION Minimizing the length of the ileal segment needed for Hautmann neobladder reconstruction is feasible and provides better long-term results than larger-volume neobladders.
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Affiliation(s)
| | - Adelina Hrkac
- Department of Urology, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Slaven Ovcaricek
- Department of Urology, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Pero Bokarica
- Department of Urology, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Ivan Gilja
- Department of Urology, University Hospital "Sveti Duh", Zagreb, Croatia
- Department of Urology, University Hospital Mostar, Mostar, Bosnia and Herzegovina
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3
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Yuk HD, Kim JJ, Ku JH, Kwak C, Kim HH, Jeong CW. Korean version of the convalescence and recovery evaluation: translation and linguistic validation. Prostate Int 2020; 8:158-166. [PMID: 33425793 PMCID: PMC7767938 DOI: 10.1016/j.prnil.2020.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 04/30/2020] [Accepted: 05/07/2020] [Indexed: 10/25/2022] Open
Abstract
Background To develop a Korean version of the original English version of the convalescence and recovery evaluation (CARE) questionnaire. The linguistic validation of the CARE questionnaire was tested on Korean patients who underwent abdominal and pelvic surgery. Methods The CARE questionnaire was translated and validated linguistically in the following steps. Permission to translate the Korean version of the original version, forward translation into the Korean, reconciliation, backward translation into English, cognitive debriefing through patient interviews, and finally proofreading. Results The forward translation was carried out by two independent bilingual translators with non-medical backgrounds. In the translation step to Korean, the terms "bloated and gassy" and "trouble concentrating" were adjusted to make them easier to understand. Backward translation was performed by another translator who was not included in the forward translation. At the backward-translation stage, the Korean version was accepted without any objection, almost matching the original version except for a few words. Cognitive debriefing by means of patient interviews was performed with 10 patients admitted to the department of urology for renal, bladder, and prostate cancer for cancer treatment. There was no difficulty in understanding the content of the questionnaire. Because most of the terms were clear and understandable, no further changes were made in the panel discussion. Conclusions The Korean version of the CARE questionnaire has been verified and is ready for use. Additional testing steps are required for the psychometric performance of the Korean version of CARE.
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Affiliation(s)
- Hyeong Dong Yuk
- Department of Urology, Seoul National University Hospital, Seoul, South Korea
| | | | - Ja Hyeon Ku
- Department of Urology, Seoul National University Hospital, Seoul, South Korea
| | - Cheol Kwak
- Department of Urology, Seoul National University Hospital, Seoul, South Korea
| | - Hyeon Hoe Kim
- Department of Urology, Seoul National University Hospital, Seoul, South Korea
| | - Chang Wook Jeong
- Department of Urology, Seoul National University Hospital, Seoul, South Korea
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4
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Font A, Luque R, Villa JC, Domenech M, Vázquez S, Gallardo E, Virizuela JA, Beato C, Morales-Barrera R, Gelabert A, Maciá S, Puente J, Rubio G, Maldonado X, Perez-Valderrama B, Pinto A, Fernández Calvo O, Grande E, Garde-Noguera J, Fernández-Parra E, Arranz JÁ. The Challenge of Managing Bladder Cancer and Upper Tract Urothelial Carcinoma: A Review with Treatment Recommendations from the Spanish Oncology Genitourinary Group (SOGUG). Target Oncol 2020; 14:15-32. [PMID: 30694442 DOI: 10.1007/s11523-019-00619-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Bladder cancer is the fourth most common cancer in men and the ninth most common in women in the Western world. The management of bladder carcinoma requires a multidisciplinary approach. Optimal treatment depends on several factors, including histology, stage, patient status, and possible comorbidities. Here we review recent findings on the treatment of muscle-invasive bladder carcinoma, advanced urothelial carcinoma, upper tract urothelial carcinoma, non-urothelial carcinoma, and urologic complications arising from the disease or treatment. In addition, we present the recommendations of the Spanish Oncology Genitourinary Group for the treatment of these diseases, based on a focused analysis of clinical management and the potential of current research, including recent findings on the potential benefit of immunotherapy. In recent years, whole-genome approaches have provided new predictive biomarkers and promising molecular targets that could lead to precision medicine in bladder cancer. Moreover, the involvement of other specialists in addition to urologists will ensure not only appropriate therapeutic decisions but also adequate follow-up for response evaluation and management of complications. It is crucial, however, to apply recent molecular findings and implement clinical guidelines as soon as possible in order to maximize therapeutic gains and improve patient prognosis.
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Affiliation(s)
- Albert Font
- Medical Oncology Service, B-ARGO Group, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, Ctra Canyet, s/n, 08916, Badalona, Spain.
| | - Raquel Luque
- Medical Oncology Service, H.U. Virgen de las Nieves, Granada, Spain
| | - José Carlos Villa
- Medical Oncology Service, Hospital General Universitario Ciudad Real, Ciudad Real, Spain
| | - Montse Domenech
- Medical Oncology Service, Hospital Fundació Althaia, Manresa, Spain
| | - Sergio Vázquez
- Medical Oncology Service, Hospital Universitario Lucus Augusti, EOXI de Lugo, Cervo e Monforte, Spain
| | - Enrique Gallardo
- Oncology Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | | | - Carmen Beato
- Medical Oncology Service, Hospital Virgen de la Macarena, Seville, Spain
| | - Rafael Morales-Barrera
- Medical Oncology Service, Hospital Universitario Vall d'Hebron, Vall d'Hebron Institute of Oncology (VHIO), Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Sonia Maciá
- Medical Oncology Department, CRO Pivotal, Madrid, Spain
| | - Javier Puente
- Medical Oncology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), CIBERONC, Madrid, Spain
| | - Gustavo Rubio
- Medical Oncology Service, Hospital Universitario Fundación Jimenez Diaz, Madrid, Spain
| | - Xavier Maldonado
- Radiation Oncology Service, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - Alvaro Pinto
- Medical Oncology Service, Hospital Universitario La Paz, Madrid, Spain
| | | | - Enrique Grande
- Medical Oncology, MD Anderson Cancer Center, Madrid, Spain
| | | | - Eva Fernández-Parra
- Medical Oncology Service, Hospital Universitario Nuestra Señora de Valme, Seville, Spain
| | - José Ángel Arranz
- Medical Oncology Service, Hospital General Universitario Gregorio Marañon, Madrid, Spain
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Adamowicz J, Kuffel B, Van Breda SV, Pokrwczynska M, Drewa T. Reconstructive urology and tissue engineering: Converging developmental paths. J Tissue Eng Regen Med 2019; 13:522-533. [DOI: 10.1002/term.2812] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 10/23/2018] [Accepted: 12/17/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Jan Adamowicz
- Chair of Urology, Department of Regenerative MedicineCollegium Medicum Nicolaus Copernicus University Bydgoszcz Poland
| | - Blazej Kuffel
- Chair of Urology, Department of Regenerative MedicineCollegium Medicum Nicolaus Copernicus University Bydgoszcz Poland
| | | | - Marta Pokrwczynska
- Chair of Urology, Department of Regenerative MedicineCollegium Medicum Nicolaus Copernicus University Bydgoszcz Poland
| | - Tomasz Drewa
- Chair of Urology, Department of Regenerative MedicineCollegium Medicum Nicolaus Copernicus University Bydgoszcz Poland
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6
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Adamowicz J, Van Breda SV, Kloskowski T, Juszczak K, Pokrywczynska M, Drewa T. Constructing artificial urinary conduits: current capabilities and future potential. Expert Rev Med Devices 2018; 16:135-144. [PMID: 30588868 DOI: 10.1080/17434440.2019.1562901] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Intestinal segments are currently used in reconstructive urology to create urinary diversion after cystectomy. Ileal conduit (IC) is the dominant type of urinary diversion. Nevertheless, IC is not an ideal solution as the procedure still requires entero-enterostomy to restore the bowel continuity. This step is a source of relevant complications that might prolong recovery time. Fabrication of artificial urinary conduit is a tempting idea to introduce an alternative form of urinary diversion which might improve cystectomy outcomes. AREAS COVERED The aim of this review is to discuss available research data about artificial urinary conduit and identify major challenges for future studies. EXPERT OPINION Fabrication of artificial urinary conduit is in range of current tissue engineering technology but there are still many challenges to overcome. There is an urgent need for studies to be conducted on large animal models with long follow up to expose the limitation of experimental strategies and to gather data for translational research.
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Affiliation(s)
- Jan Adamowicz
- a Chair of Urology, Department of Regenerative Medicine, Collegium Medicum , Nicolaus Copernicus University , Bydgoszcz , Poland
| | - Shane V Van Breda
- b Department of Biomedicine , University Hospital Basel , Basel , Switzerland
| | - Tomasz Kloskowski
- a Chair of Urology, Department of Regenerative Medicine, Collegium Medicum , Nicolaus Copernicus University , Bydgoszcz , Poland
| | - Kajetan Juszczak
- c Department of Urology , Memorial Rydygier Hospital , Cracow , Poland
| | - Marta Pokrywczynska
- a Chair of Urology, Department of Regenerative Medicine, Collegium Medicum , Nicolaus Copernicus University , Bydgoszcz , Poland
| | - Tomasz Drewa
- a Chair of Urology, Department of Regenerative Medicine, Collegium Medicum , Nicolaus Copernicus University , Bydgoszcz , Poland
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Adamowicz J, Pokrywczynska M, Van Breda SV, Kloskowski T, Drewa T. Concise Review: Tissue Engineering of Urinary Bladder; We Still Have a Long Way to Go? Stem Cells Transl Med 2017; 6:2033-2043. [PMID: 29024555 PMCID: PMC6430044 DOI: 10.1002/sctm.17-0101] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/18/2017] [Indexed: 12/18/2022] Open
Abstract
Regenerative medicine is a new branch of medicine based on tissue engineering technology. This rapidly developing field of science offers revolutionary treatment strategy aimed at urinary bladder regeneration. Despite many promising announcements of experimental urinary bladder reconstruction, there has been a lack in commercialization of therapies based on current investigations. This is due to numerous obstacles that are slowly being identified and precisely overcome. The goal of this review is to present the current status of research on urinary bladder regeneration and highlight further challenges that need to be gradually addressed. We put an emphasis on expectations of urologists that are awaiting tissue engineering based solutions in clinical practice. This review also presents a detailed characteristic of obstacles on the road to successful urinary bladder regeneration from urological clinician perspective. A defined interdisciplinary approach might help to accelerate planning transitional research tissue engineering focused on urinary tracts. Stem Cells Translational Medicine 2017;6:2033-2043.
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Affiliation(s)
- Jan Adamowicz
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Marta Pokrywczynska
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Tomasz Kloskowski
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Tomasz Drewa
- Chair of Urology, Department of Regenerative Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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Mousa NA, Abou-Taleb HA, Orabi H. Stem cell applications for pathologies of the urinary bladder. World J Stem Cells 2015; 7:815-822. [PMID: 26131312 PMCID: PMC4478628 DOI: 10.4252/wjsc.v7.i5.815] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2014] [Revised: 02/05/2015] [Accepted: 04/07/2015] [Indexed: 02/06/2023] Open
Abstract
New stem cell based therapies are undergoing intense research and are widely investigated in clinical fields including the urinary system. The urinary bladder performs critical complex functions that rely on its highly coordinated anatomical composition and multiplex of regulatory mechanisms. Bladder pathologies resulting in severe dysfunction are common clinical encounter and often cause significant impairment of patient’s quality of life. Current surgical and medical interventions to correct urinary dysfunction or to replace an absent or defective bladder are sub-optimal and are associated with notable complications. As a result, stem cell based therapies for the urinary bladder are hoped to offer new venues that could make up for limitations of existing therapies. In this article, we review research efforts that describe the use of different types of stem cells in bladder reconstruction, urinary incontinence and retention disorders. In particular, stress urinary incontinence has been a popular target for stem cell based therapies in reported clinical trials. Furthermore, we discuss the relevance of the cancer stem cell hypothesis to the development of bladder cancer. A key subject that should not be overlooked is the safety and quality of stem cell based therapies introduced to human subjects either in a research or a clinical context.
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9
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Asgari MA, Safarinejad MR, Shakhssalim N, Soleimani M, Shahabi A, Amini E. Sexual function after non-nerve-sparing radical cystoprostatectomy: a comparison between ileal conduit urinary diversion and orthotopic ileal neobladder substitution. Int Braz J Urol 2014; 39:474-83. [PMID: 24054377 DOI: 10.1590/s1677-5538.ibju.2013.04.04] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Accepted: 12/04/2012] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To compare the erectile function (EF) and sexual desire (SD) in men after radical cystoprostatectomy (RCP) who had either an ileal conduit urinary diversion or orthotropic ileal neobladder substitution. MATERIALS AND METHODS Eighty one sexually active men with bladder cancer were enrolled in this prospective study. After RCP according to patients' preferences they underwent either ileal conduit urinary diversion (n = 41) or orthotropic ileal neobladder substitution (n = 40). EF and SD were assessed using International Index of Erectile Function (IIEF) questionnaire. Patients were assessed at 4-week before surgery and were followed up at 1, 6, and 12-month postoperatively using the same questionnaire. RESULTS Postoperatively the EF and SD domains deteriorated significantly in both groups, but in a small proportion of the patients submitted to ileal neobladder they gradually improved with time (P = 0.006). At 12-month postoperative period, 4 (9.8 %) and 14 (35.0 %) patients in ileal conduit and ileal neobladder groups were able to achieve erections hard enough for vaginal penetration and maintained their erection to completion of intercourse, respectively (P = 0.006). Among patients in the ileal conduit and ileal neobladder groups, additional 4 (9.8 %) and 7 (17.1 %) patients were able to get some erection, but were unable to maintain their erection to completion of intercourse (P = 0.02). At 12-month follow up period 24.4 % of the ileal conduit and 45.0 % of the ileal neobladder patients rated their sexual desire very high or high (P = 0.01). CONCLUSION When performed properly, orthotopic ileal neobladder substitution after RCP offers better long-term results in terms of EF and SD.
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Affiliation(s)
- M A Asgari
- Department of Urology, Shahid Modarress Hospital, Shahid Beheshti University of Medical Sciences, Iran
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10
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Abstract
We present a review on the current options for continent urinary diversion and their different indications on the basis of patient selection. In current clinical practice continent urinary diversion is being used world-wide in patients undergoing radical cystectomy and in severe cases of benign bladder pathologies. We also discuss the specific complications of continent urinary diversion and highlight the need to rigorously monitor these patients in the long- term specifically in terms of their renal function and cancer recurrence.
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Affiliation(s)
- Andrew Moon
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK
| | - Nikhil Vasdev
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK
| | - Andrew C. Thorpe
- Department of Urology, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK
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Asgari MA, Safarinejad MR, Shakhssalim N, Soleimani M, Shahabi A, Amini E. Quality of life after radical cystectomy for bladder cancer in men with an ileal conduit or continent urinary diversion: A comparative study. Urol Ann 2013; 5:190-6. [PMID: 24049384 PMCID: PMC3764902 DOI: 10.4103/0974-7796.115747] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 06/12/2012] [Indexed: 11/04/2022] Open
Abstract
AIM To investigate quality of life (QoL) domains with three forms of urinary diversions, including ileal conduit, MAINZ pouch, and orthotopic ileal neobladder after radical cystectomy in men with muscle-invasive bladder cancer. MATERIALS AND METHODS In a prospective study, 149 men underwent radical cystectomy and urinary diversion (70 ileal conduit, 16 MAINZ pouch, and 63 orthotopic ileal neobladder). Different domains of QoL, including general and physical conditions, psychological status, social status, sexual life, diversion-related symptoms, and satisfaction with the treatment were assessed using an author constructed questionnaire. Assessment was performed at three months postoperatively. RESULTS In questions addressing psychological status, social status, and sexual life, patients with continent diversion had a more favorable outcome (P = 0.002, P = 0.01, and P = 0.002, respectively). The rate of erectile dysfunction did not differ significantly between the three groups (P = 0.21). The rate and global satisfaction was higher with the MAINZ pouch (68.7%) and ileal neobladder (76.2%) as compared with the ileal conduit group (52.8%) (P = 0.002). CONCLUSION Continent urinary diversion after radical cystectomy provides better results in terms of QoL as compared with ileal conduit diversion.
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Affiliation(s)
- M A Asgari
- Department of Urology, Shahid Modarress Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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12
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Nam JK, Kim TN, Park SW, Lee SD, Chung MK. The Studer orthotopic neobladder: long-term (more than 10 years) functional outcomes, urodynamic features, and complications. Yonsei Med J 2013; 54:690-5. [PMID: 23549816 PMCID: PMC3635617 DOI: 10.3349/ymj.2013.54.3.690] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2012] [Revised: 08/04/2012] [Accepted: 08/13/2012] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Radical cystectomy and urinary diversion are the standard treatment for invasive bladder cancer. We analyzed the long-term (>10 years postoperatively) functional outcomes, complications, and urodynamic findings in a single center series of patients who underwent cystectomy and a Studer ileal neobladder substitution. MATERIALS AND METHODS A retrospective chart review of 108 Studer pouches constructed during 1990 and 2011 was performed. Data were analyzed in terms of long-term (>10 years) outcomes. Complications, incontinence, voiding difficulties, upper urinary tract changes, overall satisfaction, and urodynamic findings of the reservoir were obtained. RESULTS We evaluated 19 out of 50 patients who had lived for over 10 years postoperatively. Another 31 patients were not traced: 7 patients died following recurrence, 15 died due to exacerbation of a comorbidity, and 9 patients were lost to follow-up. Concerning complications, 6 patients had an atrophied kidney, 5 patients had moderate hydronephrosis, 5 patients had chronic recurrence of pylelonephritis, and 2 patients had voiding difficulty because of bladder neck stricture due to clean intermittent catheterization. One patient underwent an operation due to intestinal obstruction. Seven patients had incontinence; all 7 patients showed intermittently at night and 2 patients even in waking hours. Maximum bladder capacity was 484.1±119.2 mL, maximum flow rate was 13.6±9.7 mL/sec, and post-void residual urine volume was 146.8±82.7 mL. CONCLUSION Long-term outcomes with the Studer orthotopic ileal neobladder have an acceptable complication rate and good functional results. However, potential adverse outcomes such as renal deterioration, dysfunctional voiding should also be considered.
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Affiliation(s)
- Jong Kil Nam
- Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Tae Nam Kim
- Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sung Woo Park
- Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Sang Don Lee
- Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
| | - Moon Kee Chung
- Department of Urology, Research Institute for Convergence of Biochemical Science and Technology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Korea
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13
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Shu'aibu S, Liman H, Akpayak I, Ofoha C, Ramyil V, Dakum N. Preliminary experience with radical cystectomy and w-ileal pouch for muscle invasive transitional cell bladder carcinoma. JOURNAL OF THE WEST AFRICAN COLLEGE OF SURGEONS 2012; 2:25-37. [PMID: 25452976 PMCID: PMC4170286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Radical cystectomy and bilateral pelvic lymphadenectomy is considered the treatment of choice for patients with muscle invasive transitional cell bladder cancer. Following radical cystectomy the surgeon would choose an appropriate modality of urinary diversion from a plethora of methods. Radical cystectomy with any type of diversion remains a complication-prone surgery. This study aims at reviewing the peri-operative challenges and morbidities experienced with radical cystectomy and W-ileal pouch urinary diversion in a tertiary hospital in Nigeria. AIMS & OBJECTIVE To report experience with radical cystectomy and W-ileal pouch construction in patients with muscle invasive transitional cell urinary bladder carcinoma. PATIENTS & METHODS The case notes of patients diagnosed with muscle invasive transitional cell bladder carcinoma (T2/3NoMo) who underwent radical cystectomy and W-ileal pouch construction from December 2006 to December 2011 at the Jos University Teaching Hospital, Jos, Nigeria were retrospectively studied. Patients were evaluated for age, sex, duration of surgery, estimated blood loss, duration of hospital stay, and complications after surgery. RESULTS Six patients had their records reviewed. Mean age was 55.8 years (range 32 - 66years). Male to female ratio was 5:1. Mean hospital stay was 31 days, with all of the patients requiring intensive care for a mean of 24 hours (range 24-72 hours). Mean hospital stay was 31 days (range 21-40 days). Mean estimated blood loss was 891 ml (range 720-1500ml). Mean duration of surgery was 10.3 hours (range 8-12 hours). Commonest complication was urine retention secondary to mucus plug in 50%. Operative mortality was 16.7%. CONCLUSION Radical cystectomy and W-ileal pouch construction due to its technical complexity and challenging postoperative management necessitates a team approach with experienced surgeons, anesthetists, intensivists and stoma care specialist, among others.
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Affiliation(s)
- Si Shu'aibu
- Division of Urology, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Hu Liman
- Division of Urology, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Ic Akpayak
- Division of Urology, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Cg Ofoha
- Division of Urology, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Vm Ramyil
- Division of Urology, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
| | - Nk Dakum
- Division of Urology, Department of Surgery, Jos University Teaching Hospital, Jos, Nigeria
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