Severin T, Bub P, Jocham D, Kausch Ingo
Klinik für Urologie, Helios Klinik Schwerin, Schwerin.
Aktuelle Urol. 2010 Jul;41(4):245-51. doi: 10.1055/s-0030-1247394. Epub 2010 Jun 1.
Published evidence does not support a clear advantage in quality of life for continent versus incontinent urinary diversion or vice versa.
We retrospectively assessed 61 patients after radical cystectomy with the EORTC-QLQ-C30 and -BLM30 instruments. Analysis was performed in dependence of age, sex, technique of urinary diversion and time-course of therapy.
36 patients had an incontinent and 20 patients a continent urinary diversion. Younger patients (p = 0.001) and those with a continent urinary diversion (p = 0.03) were found to have a statistically significant higher incidence of financial problems. Also patients with continent urinary diversion had significantly (p = 0.032) more problems in social integration. Furthermore, there were significant differences in social integration (p = 0.03) and emotional ability (p = 0.008) in the age-dependent analysis. Patients with a continent diversion had significantly more meteoristic problems (p = 0.007).
This study also could not demonstrate any clear differences in dependence on the technique of urinary diversion. A good postoperative quality of life seems possible independent of age.
已发表的证据并不支持可控性尿流改道术与不可控性尿流改道术在生活质量方面具有明显优势，反之亦然。
我们使用欧洲癌症研究与治疗组织生活质量问卷C30（EORTC-QLQ-C30）和膀胱癌模块问卷（-BLM30）对61例根治性膀胱切除术后的患者进行了回顾性评估。根据年龄、性别、尿流改道技术和治疗时间进程进行分析。
36例患者采用不可控性尿流改道术，20例患者采用可控性尿流改道术。发现年轻患者（p = 0.001）和采用可控性尿流改道术的患者（p = 0.03）在经济问题方面的发生率具有统计学意义上的显著更高。此外，采用可控性尿流改道术的患者在社会融入方面也存在显著更多问题（p = 0.032）。在年龄依赖性分析中，社会融入（p = 0.03）和情感能力（p = 0.008）也存在显著差异。采用可控性尿流改道术的患者有明显更多的胃肠胀气问题（p = 0.007）。
本研究也未能证明根据尿流改道技术存在任何明显差异。似乎无论年龄如何，术后都有可能获得良好的生活质量。
