Miyake Hideaki, Nakamura Ichiro, Eto Hiroshi, Gotoh Akinobu, Fujisawa Masato, Okada Hiroshi, Arakawa Soichi, Kamidono Sadao, Hara Isao
Department of Urology, Kobe University School of Medicine, Japan.
Urol Int. 2002;69(3):195-9. doi: 10.1159/000063944.
The objective of this study was to determine whether the quality of life (QOL) in patients who underwent orthotopic bladder replacement after radical cystectomy was affected by the intestinal segment used for the creation of a neobladder.
A total of 52 patients who underwent radical cystectomy for bladder cancer were included in this study; i.e., 24 patients with an ileal neobladder and 28 patients with a sigmoid neobladder. QOL was evaluated using the SF-36 health-related QOL survey and a questionnaire designed to evaluate the continent status.
The mean follow-up periods for patients with an ileal and a sigmoid neobladder was 40.2 and 43.1 months, respectively. The SF-36 survey revealed that patients with colon neobladder had a significantly higher score for role-emotional functioning than those with ileal neobladder, while there was no significant difference in the remaining seven scores between patients with ileal and colon neobladders; however, general health and social functioning in patients with both types of neobladder appeared to be significantly lower than those in the general population in the United States. The results of the questionnaire analyzing the continent status were also similar between these two groups, including the desire to urinate, the incidence of both day- and nighttime urinary leakage, the frequency of pad exchange, and the concern of urine odor.
Six of the eight scales concerning health-related QOL were favorable with both patients with ileal and colon neobladders, and the health-related QOL in orthotopic neobladder patients except for role-emotional functioning was not affected by the segment of the intestine used for neobladder construction. Moreover, no significant differences were observed in the QOL associated with continent status between these two groups. Therefore, patients with both types of orthotopic neobladder were generally satisfied with their health-related as well as disease-specific QOL.
本研究的目的是确定根治性膀胱切除术后接受原位膀胱替代术的患者的生活质量（QOL）是否受到用于创建新膀胱的肠段的影响。
本研究共纳入52例因膀胱癌接受根治性膀胱切除术的患者；即24例采用回肠新膀胱的患者和28例采用乙状结肠新膀胱的患者。使用SF-36健康相关生活质量调查问卷和一份旨在评估控尿状态的问卷对生活质量进行评估。
回肠新膀胱和乙状结肠新膀胱患者的平均随访期分别为40.2个月和43.1个月。SF-36调查显示，结肠新膀胱患者在角色情感功能方面的得分显著高于回肠新膀胱患者，而回肠和结肠新膀胱患者在其余七个得分方面无显著差异；然而，两种新膀胱患者的总体健康和社会功能似乎均显著低于美国普通人群。分析控尿状态的问卷结果在这两组之间也相似，包括排尿欲望、白天和夜间尿漏的发生率、更换尿垫的频率以及对尿液气味的担忧。
与健康相关生活质量的八个量表中的六个对回肠和结肠新膀胱患者均有利，除角色情感功能外，原位新膀胱患者的健康相关生活质量不受用于新膀胱构建的肠段的影响。此外，两组之间在与控尿状态相关的生活质量方面未观察到显著差异。因此，两种原位新膀胱患者对其健康相关以及疾病特异性生活质量总体上都感到满意。
