QUALITY-OF-LIFE AFTER CYSTECTOMY AND URINARY-DIVERSION - RESULTS OF ARETROSPECTIVE INTERDISCIPLINARY STUDY

Purpose: Now that creation of continent urinary reservoirs has become a standardized and clinically well established surgical technique with known morbidity and mortality rates, we reassessed the psychological and social aspects of this treatment compared with wet urostomy. Mater ials and Methods: We developed a questionnaire (102 items) addressing general aspects of quality of life, disease related social support, co ping strategies and stoma related issues. It was mailed to 600 patient s with ileal conduits and 130 with continent reservoirs. Final analysi s was restricted to 192 patients operated upon within the last 5 years (mean followup 2,7 years). Results: The resulting groups were matched and paralleled regarding most treatment related and sociodemographic data. Final analysis did not reveal differences between the groups in disease related social support, coping strategies or quality of life w hen expressed as a total score. me found statistically significant sup eriority of continent reservoirs regarding all stoma related items, pa tient global self-assessment of their quality of life (single item, p < 0.005), physical strength, mental capacity, leisure time activities and social competence (p < 0.05). Conclusions: Continent diversion is clearly advantageous with respect to all items directly related to the stoma. The significant superiority of continent diversion in patient global self-assessment of their quality of life reflects the highly su bjective dimension of the concept. Superiority in self-ratings of phys ical strength, mental capacity, leisure time activities and social com petence could be interpreted as indicators of enhanced vitality in tho se patients, thus, supporting our understanding that women and men who actively participate in life have a special benefit from continent re servoirs.