Assessment of health-related quality of life of male patients with ileal orthotopic neobladder compared to cutaneous ureterostomy

Arman Tsaturyan; Mher Beglaryan; Yervand Kirakosyan; Davit Martirosyan; Mher Mkhitaryan; Varujan Shahsuvaryan; Sergey Fanarjyan; Ashot Tsaturyan

doi:10.5173/ceju.2020.0028

Assessment of health-related quality of life of male patients with ileal orthotopic neobladder compared to cutaneous ureterostomy

Cent European J Urol. 2020;73(2):160-166. doi: 10.5173/ceju.2020.0028. Epub 2020 May 9.

Authors

Arman Tsaturyan^{1

2}, Mher Beglaryan³, Yervand Kirakosyan¹, Davit Martirosyan¹, Mher Mkhitaryan⁴, Varujan Shahsuvaryan¹, Sergey Fanarjyan¹, Ashot Tsaturyan²

Affiliations

¹ Department of Urology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia.
² Department of Urology, 'Artmed' Medical Rehabilitation Center, Yerevan, Armenia.
³ Faculty of Informatics and Applied Mathematics, Yerevan State University, Yerevan, Armenia.
⁴ Department of Urology, 'Armenia' Republican Medical Center, Yerevan Armenia.

Abstract

Introduction: The aim of this article was to compare patients' health-related quality of life (HR-QoL) outcomes between ileal orthotopic neobladder (IONB) and standard bilateral cutaneous ureterostomy (CU) using validated diversion-specific HR-QoL questionnaires.

Material and methods: This study utilized a retrospective cohort design, including all male patients who underwent open radical cystectomy with either IONB or CU from January 2010 until December 2017. In total, 69 and 57 male patients with a minimum of 12 months of follow-up were included in each group respectively, after applying the following exclusion criteria: female, pre- and postoperative radio- and chemotherapy and palliative surgery. For every patient, HR-QoL was evaluated using the European Association of Research and Treatment of Cancer Quality of Life Core (EORTC-QLQ-C30) and Functional Assessment of Cancer Therapy for patients undergoing radical cystectomy (FACT-Bl-Cys) validated questionnaires.

Results: In multivariable analysis, the type of the urinary diversion, and the occurrence of early and late postoperative complications were independently associated with the change of scores of HR-QoL domains. When comparing the 2 surgical methods (IONB vs. CU), after adjusting for confounders, such EORTC-QLQ-C30 domains as physical functioning (66.5 vs. 57.9, p = 0.011) and global health status (58.1 vs. 42.6, p <0.001) were superior in the IONB arm which was statistically significant. Similarly, functional health (15.3 vs. 11.9, p <0.001) and total score (110.1 vs. 101.7, p = 0.009) from the FACT-Bl-Cys questionnaire were superior in the IONB arm.

Conclusions: In our study, patients with IONB possessed statistically significant, better scores of HR-QoL domains assessed with EORTC-QLQ-C30 and FACT-Bl-Cys questionnaires compared to those with CU. The occurrence of early major and late complications negatively affected patients' HR-QOL.

Keywords: cutaneous ureterostomy; health-related quality of life; orthotopic neobladder; radical cystectomy; urinary diversion.

Copyright by Polish Urological Association.