Review Article

Muscle Invasive Bladder Cancer: From Diagnosis to Survivorship

Table 2

Quality of life in patients treated with continent and incontinent urinary diversion.

Author (Year)LocationSample size Scale(s) used Principal findings
ICCCDNB

Prospective longitudinal studies of quality of life in patients treated with urinary diversion

Hardt et al. [8] (2000)Germany2420SF-36, Self-designSexual fxn similar, all SF-36 domains returned to baseline by 1yr except physical fxn.
Note: 75% would choose the same diversion
Somani et al. [50] (2009)UK293SEIQoL-DW, SWLS, EORTC QLQ-C30“Family”, “health”, “relationships”, and “finance” identified as biggest contributors to QoL

Cross-sectional studies of quality of life in patients treated with urinary diversion

Boyd et al. [35] (1987)USA8785BDI, POMS, Self-designPreoperative education important for adaptation.
CCD: more likely to be sexually active
Mansson et al. [51] (1988)Sweden4020Self-designIC: more problems with stomal issues such as leakage + odor
Bjerre et al. [52] (1995)Denmark2938Self-designNB with greater incontinence, but IC with greater distress from leakage and lower body image
Gerharz et al. [36] (1997)Germany13161Self-designSimilar coping strategies, social support.
CCD: Better global QOL and fewer stomal issues
Okada et al. [6] (1997)Japan6374Self-designCCD: less local stoma problems; greater satisfaction
Hart et al. [37] (1999)USA25931034 Self-report questionnairesOverall, high QOL in all groups.
IC: worse social function
Kitamura et al. [53] (1999)Japan362221EORTC QLQ-C30Similar overall QOL between groups.
IC: more trouble with public restrooms + travel
Fujisawa et al. [39] (2000)Japan2036SF-36Similar QOL between diversion types
McGuire et al. [54] (2000)USA381638SF-36IC: statistically lower mental well being than population-based norm.
Conde Redondo et al. [55] (2001)Spain627Self-designIC: greater distress with urine leakage + lower body image
Hobisch et al. [56] (2001)Austria3369EORTC QLQ-C30NB better across all domains
Dutta et al. [57] (2002)USA2349SF-36, FACT-GNB marginally better on several domains

Cross-sectional studies of quality of life in patients treated with urinary diversion

Hara et al. [58] (2002)Japan3748SF-36, Self-designEquivalent in all domains of SF-36
Mansson et al. [59] (2002)Sweden3529FACT-BL, HADSNB: more problems with incontinence
Protogerou et al. [60] (2004)Greece5850EORTC QLQ-C30Included matched 54 patient control group. IC with greater urine odor and day and nighttime leakage than NB or controls.
Allareddy et al. [61] (2006)USA5626FACT-BLCompared to intact bladder ( ): Sexual fxn lower in individuals undergoing cystectomy. Similar QOL between diversion groups.
Kikuchi et al. [40] (2006)Japan201415FACT-BLOverall QOL similar between groups.
NB: worse urinary control, better body image
Gilbert et al. [33] (2007)USA66122BCIUrinary, bowel and sexual differences exist by diversion type. NB may have worse urinary fxn
Saika et al. [62] (2007)Japan563122EORTC QLQ-C30, SatisfactionAssessment of patients 75+ yrs old:
Similar QOL between diversion types, including 31 with ureterocutaneostomy.
Harano et al. [63] (2007)Japan2021SF-36, Self-designSimilar QOL between diversion types
Philip et al. [64] (2009)United Kingdom2428SF-36Overall QOL similar
NB: Better physical function
Sogni et al. [65] (2008)Italy1816EORTC: QLQ-C30, QLQ-BLM30Assessment of patients 75+ yrs old: Similar QOL between diversion types.
NB: 56% and 25% daytime and nighttime complete continence rates
Hedgepeth et al. [19] (2010)USA89144BCI, EORTC BISIncluded bladder-intact comparison group ( ); NB: Lower urinary function.
Body Image is similar between NB and IC.

Note. Urinary Diversion Type: IC: Ileal conduit, CD: Continent cutaneous diversion, NB: Orthotopic Neobladder.
“Self-design”: questionnaires developed specifically for the study.
SF-36: Medical Outcomes Study 36-Item Short Form.
HADS: Hospital Anxiety and Depression Scale.
EORTC BIS: European Organization for the Research and Treatment of Cancer Body Image Scale.
SEIQoL-DW: Schedule for Evaluation of Individual Quality of Life-Direct Weighting.
SWLS: Satisfaction With Life Scale.
BDI: Beck Depressive Inventory.
POMS: The Profile of Mood States.