Quality of life and functional outcomes after radical cystectomy with ileal orthotopic neobladder replacement for bladde
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ORIGINAL ARTICLE
Quality of life and functional outcomes after radical cystectomy with ileal orthotopic neobladder replacement for bladder cancer: a multicentre observational study V. Tostivint1 · G. Verhoest2 · B. Cabarrou3 · J. Gas1,4 · P. Coloby4 · J. Zgheib1 · M. Thoulouzan1 · M. Soulié1 · X. Gamé1 · J. B. Beauval1 · E. Pons‑Tostivint5 · M. Roumiguié1 Received: 25 August 2020 / Accepted: 3 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Ileal orthotopic neobladder (IONB) reconstruction is the preferred urinary diversion among selected patients who have undergone radical cystectomy (RC) for bladder cancer (BCa). There is insufficient data regarding patients’ quality of life (QoL), sexual and urinary outcomes. Our objectives were to assess QoL in a multicentre cohort study, and to identify related clinical, oncological and functional factors. Methods Patients who underwent RC with IONB reconstruction for BCa from 2010 to 2017 at one of the three French hospitals completed the following self-reported questionnaires: European Organization for Research and Treatment of Cancer (EORTC) generic (QLQ-C30) and bladder cancer specific instruments (QLQ-BLM30). To assess urinary symptoms, patients completed the Urinary Symptom Profile questionnaire (USP) and a three-day voiding diary. Univariate and multivariate analyses were computed to identify clinical, pathological, and functional predictors of global QoL score. Results Seventy-three patients completed questionnaires. The median age was 64 years and 86.3% were men. The median interval between surgery and responses to questionnaires was 36 months (range 12–96). Fifty-five percent of patients presented a high global QoL (EORTC-QLQC30, median score 75). A pre-RC American Society of Anesthesiologists score > 2, active neoplasia, sexual inactivity, and stress urinary incontinence were associated with a worse QoL. After a multivariate analysis, sexual inactivity was the only independent factor related to an altered QoL. Conclusion Patients with IONB reconstruction after RC have a high global QoL. Sexual activity could independently impact the global QoL, and it should be assessed pre- and post-operatively by urologists. Keywords Radical cystectomy · Ileal orthotopic neobladder · Bladder cancer · Quality of life · Functional outcomes · Name of questionnaires
E. Pons-Tostivint and M. Roumiguié have equally contributed to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00345-020-03484-6) contains supplementary material, which is available to authorized users. * V. Tostivint [email protected] 1
Department of Urology, Andrology and Renal Transplantation, Rangueil University Hospital, 1, Avenue du Pr Jean Poulhès, 31400 Toulouse, France
2
Department of Urology, University Hospital, Rennes, France
3
Department of Biostatistics, Claudius Regaud Institute, Toulouse University Cancer Institute-Oncopole, Toulouse, France
4
Department of Urology, R
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