[Urinary diversion after cystectomy: aspects of quality of life and options for rehabilitation].

Radical cystectomy in combination with different types of continent and incontinent urinary diversion is an integral part of the treatment concept for bladder tumors. Although in principle this operation does not cause disability in general, it represents a potentially massive encroachment on the physical and psychological integrity of the individual. The term "quality of life" appears with increasing frequency in modern concepts of evidence-based medicine. Also recognition of the subjective assessment of treatment by those affected in comparison to the "objective" view of qualified doctors and functionaries has become more relevant.Nevertheless, few studies have analyzed the "quality of life" after cystectomy. In addition, methodological factors hinder comparability. Only a few authors have used validated measuring instruments that allow comparison of the data. Low case numbers limit the statistical significance. Besides typical postoperative consequences and their effect on quality of life, potential influences on the pre- and postoperative assessment in the intraindividual course are discussed. The authors argue in favor of postoperative urological rehabilitation in qualified urological centers to optimize physical and psychological coping with the new life situation of "cystectomy with urinary diversion."