Quality of life in patients with urinary diversion after operation for locally advanced rectal cancer

Aims: When locally advanced or recurrent rectal cancer involves the bladder or prostate, curative treatment often requires pelvic exenteration. The ai m was to assess the quality of life (QoL) in disease-free patients with uri nary diversion after extensive surgery for advanced rectal cancer. Methods; Twelve patients with urinary diversion (cases) were compared with 25 randomly selected patients given the same treatment, but without urinary diversion (controls). An age- and gender-adjusted general population was i dentified (reference). QoL was assessed with the EORTC questionnaires QLQ-C 30, QLQ-CR38, and parts of the QLQ-BLM30. Results: The cases did not report significantly worse overall QoL than the controls or the reference population. Both cases and controls had low mean scores of sexual function, and high mean scores of male sexual problems. In the nine cases that had two stomas, overall QoL was not worse than in the control or reference groups. Conclusions: Tumour-free patients did not report worse QoL scores than the controls or the general population, despite most having two stomas and low sexual function. Fear of reducing the patient's QoL should not be a major c ontraindication when surgery with urinary diversion is warranted to obtain curative resection. (C) 2001 Harcourt Publishers Ltd.