Distressful symptoms after radical cystectomy with urinary diversion for urinary bladder cancer: A Swedish population-based study

Objective:To study the excess prevalence of distressful symptoms after radi cal surgery for urinary bladder cancer. Methods:We included all patients who underwent cystectomy due to bladder ca ncer before 1996 in Stockholm County. A control group was randomly selected from the general population. Information was collected by means of an anon ymous postal questionnaire. Results: Completed questionnaires were returned by 310 (71%) controls and 2 51 (85%) cystectomized individuals. A 5-fold (reservoir) and 9-fold (condui t) increase in defecation urgency and a 4-fold (reservoir) and 6-fold (cond uit) increase in faecal leakage were reported in individuals operated on. U rinary tract infection was increased 3-fold in cystectomized individuals co mpared with controls, during the previous year 26% of the patients reported a symptomatic infection. The perception of a reduced physical attractivene ss due to disease was more than 5-fold increased in the men operated on com pared to the controls. The majority, 135 out of 201 (67%), reported that th ey would have refused alternative bladder-sparing procedures if they decrea sed the prospects of survival by even as little as 1%. Conclusions: The patient's situation after cystectomy is considerably impai red due to changed bowel and sexual function, urinary tract infections and a sense of decreased attractiveness. However, most patients are in spite of this unwilling to compromise survival. Copyright (C) 2001 S. Karger AG, Ba sel.