Comparison of Quality of Life of Patients Following Cystectomy for Malignant Versus Benign Urinary Bladder Pathology - Abstract
Introduction: We assess post-operative quality of life (QoL) for cystectomy and ileal conduit urinary diversion (CX) patients in Northern Ireland, comparing those with malignant and benign indications for surgery. Methods: We reviewed notes CX patients, between 1992 and 2010. A QoL-questionnaire (EORTC QLQ-C30) was distributed to surviving patients, additionally post-procedure general-practitioner (GP) attendances for suspected and proven urinary tract infections (UTI) and related hospital admissions were logged. Results: Eighty CX cases were identified in the study period. 31 deceased patients were excluded from study. All patients underwent CX for benign (CB) (n=26) or malignant (CM) (n=23) bladder/pelvic conditions. Mean age in these groups was 45.7 and 65.8 years respectively. Mean number of GP visits with suspected UTI was 77.8 for CB and 31.1 for CM (p<0.001). Mean number of hospital admissions for procedure related complications was 19 for CB and 6for CM (p <0.001). EORTC QLQ-C30 questionnaire; the average functional and symptom scale were both worse post-operatively for CM, however the global health related QoL was better in these patients. Conclusion: We hypothesise that patient expectation of outcomes differ between CX for benign and malignant conditions contributing to significantly different QoL outcomes. Outcomes in the well-studied malignant group cannot be directly applied to those with benign indications for surgery. Those undergoing CX for benign conditions have significantly more unplanned healthcare attendances post-operatively. Further detailed study of QoL in benign cystectomy is needed.