Health-related quality of life in patients undergoing radical cystectomy with modified single stoma cutaneous ureterosto
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UROLOGY - ORIGINAL PAPER
Health‑related quality of life in patients undergoing radical cystectomy with modified single stoma cutaneous ureterostomy, bilateral cutaneous ureterostomy and ileal conduit Tsaturyan Arman1,2 · Beglaryan Mher3 · Shahsuvaryan Varujan1 · Fanarjyan Sergey1 · Tsaturyan Ashot2 Received: 2 March 2020 / Accepted: 13 April 2020 © Springer Nature B.V. 2020
Abstract Purpose To compare the clinical outcomes and patients’ health-related quality of life (HR-QoL) with modified single stoma cutaneous ureterostomy (MCU), bilateral standard cutaneous ureterostomy (SCU) and ileal conduit (IC) using validated diversion-specific HR-QoL instrument. Methods The study included 70 patients who underwent open radical cystectomy with either MCU, SCU, or IC from May 2017 to May 2018. In total 23, 25 and 22 patients were included in each group, respectively, after applying the following exclusion criteria: female, pre- and postoperative radio and chemotherapy, palliative surgery. HR-QoL was evaluated using the European Association of Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC-QLQ-C30) and Functional Assessment of Cancer Therapy for patients undergoing radical cystectomy (FACT-Bl-Cys). Results Global health status per EORTC-QLQ-C30 was the only domain that was found to be statistically better in the IC group compared to MCU (p = 0.007). Higher scores in additional concerns (p = 0.008), functional health domains (p = 0.002), satisfaction from urinary diversion (p = 0.004), and total score (p = 0.027) per FACT-Bl-Cys questionnaire, global health status (p IIIa as major. Ileus lasting more than 5 days was considered mechanic and re-laparotomy was performed to treat patients. All variables were first tested in univariate models. Thereafter, separate multiple linear regressions were performed for all domains and item scales of both of the questionnaires (as dependent variables) with all the factors which appeared to be statistically significant in the univariate analysis as independent variables. P IIIa), n (%) Catheter-free rate, n (%)
Table 2 Description of early (30-day) postoperative complications according to Clavien–Dindo classification
Surgical technique
P value
IC (n-22)
SCU (n-25)
MCU (n-23)
60 (55–65) 25.1 (22.6–28.4) 13 (18.6) 10 (14.3)
57 (53–63) 25.6 (23.8–28.0) 3 (13.6) 3 (13.6)
61 (55–65) 25.3 (22.4–28.9) 5 (20.0) 4 (16.0)
62 (57–68) 24.6 (21.8–27.6) 5 (21.7) 3 (13.0)
5 (7.1) 41 (58.6) 24 (34.3)
2 (9.1) 12 (54.5) 8 (36.4)
1 (4.0) 16 (64.0) 8 (32.0)
2 (8.7) 13 (56.5) 8 (34.8)
38 (54.3) 32 (45.7) 400 (350–450)
14 (63.6) 8 (36.4) 400 (350–450)
12 (48.0) 13 (52.0) 450 (375–475)
12 (52.2) 11 (47.8) 400 (300–450)
46 (65.7) 18 (25.7) 4 (5.7) 2 (2.9) 24 (34.3) 26 (20–30) 13 (18.6) 4 (5.7) –
15 (68.2) 6 (27.3) 1 (4.5) 0 7 (31.8) 25 (20–29) 5 (22.7) 2 (9.1) –
17 (68.0) 6 (24.0) 1 (4.0) 1 (4.0) 8 (32.0) 27 (20–31) 5 (20.0) 1 (4.0) 8 (32.0)
14 (60.9) 6 (26.1) 2 (8.7) 1 (4.3) 9 (39.1) 26 (15–32) 3 (13.0) 1 (4.3) 17 (73.9)
Early complications
Gastrointesti
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