QUALITY-OF-LIFE FOLLOWING CYSTECTOMY AND URINARY-DIVERSION RESULTS OFA RETROSPECTIVE INTERDISCIPLINARY STUDY

Continent urinary reservoirs are no longer surgical curiosities. but s erious options replacin the incontinent conduit as the standard urinar y diversion. Now that the frequency of specific complications diminish es with increasing experience the surgeon has to focus on the psycholo gic and social aspects of his treatment. In a retrospective study we i nvestigated, whether continent diversion and wet urostomy disclose sig nificant differences as to their impact on the patients' quality of li fe. For this purpose we developed an instrument based on a biopsychoso cial model of disease. The questionnaire (102 items) was mailed to 600 patients with ileal conduits from all over Germany and to 130 of our own patients with ileocecal reservoirs. The sample included in the fin al analysis was restricted to those patients treated within the last f ive years (n=192). The analysis did not reveal significant differences between the two groups concerning disease-related support and quality of life when expressed by means of the constructed instrument (total score). However, a statistically significant superiority of continent urinary diversion was found wiith regard to all the stoma related item s and the patient's global self-assessment of their quality of line (s ingle item) (p < 0,005), reflecting the subjective dimension of the co ncept. Superiority in self-ratings of physical strength, mental capaci ty, leisure time activities and social competence (p < 0,05) could be interpreted as indicators of vital power in patients with continent ur inary diversion and thus supports our understanding that especially yo ung women and men do have a benefit from continent reservoirs.