Henningsohn L, Wijkström H, Dickman P W, Bergmark K, Steineck G
Department of Urology, Huddinge University Hospital, Stockholm, Sweden.
Eur Urol. 2001 Aug;40(2):151-62. doi: 10.1159/000049766.
To study the excess prevalence of distressful symptoms after radical surgery for urinary bladder cancer.
We included all patients who underwent cystectomy due to bladder cancer before 1996 in Stockholm County. A control group was randomly selected from the general population. Information was collected by means of an anonymous postal questionnaire.
Completed questionnaires were returned by 310 (71%) controls and 251 (85%) cystectomized individuals. A 5-fold (reservoir) and 9-fold (conduit) increase in defecation urgency and a 4-fold (reservoir) and 6-fold (conduit) increase in faecal leakage were reported in individuals operated on. Urinary tract infection was increased 3-fold in cystectomized individuals compared with controls, during the previous year 26% of the patients reported a symptomatic infection. The perception of a reduced physical attractiveness due to disease was more than 5-fold increased in the men operated on compared to the controls. The majority, 135 out of 201 (67%), reported that they would have refused alternative bladder-sparing procedures if they decreased the prospects of survival by even as little as 1%.
The patient's situation after cystectomy is considerably impaired due to changed bowel and sexual function, urinary tract infections and a sense of decreased attractiveness. However, most patients are in spite of this unwilling to compromise survival.
研究膀胱癌根治性手术后痛苦症状的过度发生率。
我们纳入了1996年以前在斯德哥尔摩县因膀胱癌接受膀胱切除术的所有患者。从普通人群中随机选取一个对照组。通过匿名邮寄问卷收集信息。
310名（71%）对照组和251名（85%）接受膀胱切除术的个体返回了完整问卷。接受手术的个体报告排便急迫感增加了5倍（储尿囊）和9倍（输尿管皮肤造口术），粪便泄漏增加了4倍（储尿囊）和6倍（输尿管皮肤造口术）。与对照组相比，接受膀胱切除术的个体尿路感染增加了3倍，在前一年，26%的患者报告有症状性感染。与对照组相比，接受手术的男性因疾病导致身体吸引力下降的认知增加了5倍多。大多数人，201人中有135人（67%）报告说，如果替代膀胱保留手术哪怕只降低1%的生存前景，他们都会拒绝。
由于肠道和性功能改变、尿路感染以及吸引力下降感，膀胱切除术后患者的状况受到严重损害。然而，尽管如此，大多数患者仍不愿在生存方面做出妥协。
