Department of Urology, Nîmes University Hospital, Nîmes, France.
Neurourol Urodyn. 2018 Apr;37(4):1405-1412. doi: 10.1002/nau.23461. Epub 2018 Feb 21.
To evaluate long-term general and urinary quality of life (QOL) and sexual satisfaction in adult neurologic patients undergoing continent cystostomy surgery associated with a bladder enlargement to treat neurogenic lower urinary tract dysfunction.
Monocentre, retrospective series of adult neurologic patients who underwent continent cystostomy with bladder enlargement and followed-up in the long-term. We assessed during follow-up, urinary and renal function and patients filled QOL questionnaires on general QOL, sexuality and urinary (short form Qualiveen) disability.
Fifty-three patients were included and followed-up 77 months on average. Rates of patients' satisfaction, stomal and urethral continences were respectively of 98.7% (n = 51), 94.1% (n = 48), and 80.4% (n = 41). Impact of surgery on general QOL and autonomy were strong and positive (respective mean scores of 4.8 and 4.7 on a scale ranging from 1 to 5). Mean overall urinary Qualiveen QOL score was 0.8 (0.09-2.67) indicating a low negative impact of urinary disability on QOL. In patients <45 years, 52.6% (n = 10) reported a moderate to important improvement of their sexuality after surgery. Renal function remained stable during follow-up.
In the long-term, continent cystostomy with bladder enlargement provides great satisfaction to almost most patients. It has a strong positive impact on general and specific urinary QOL, patients' autonomy and urinary continence. In young patients a positive impact on sexuality was also noticed. These encouraging data, that need to be confirmed, constitute interesting information to provide to neurologic patients to help them deciding whether they are willing to undergo continent cystostomy surgery.
评估接受治疗神经源性下尿路功能障碍的连续膀胱造口术和膀胱扩大术的成年神经患者的长期一般和尿控生活质量（QOL）和性满意度。
单中心、回顾性系列研究纳入了接受连续膀胱造口术和膀胱扩大术的成年神经患者，并进行了长期随访。在随访期间，我们评估了患者的尿肾功能，并让患者填写了一般 QOL、性健康和尿控（短式 Qualiveen）问卷。
共纳入 53 例患者，平均随访 77 个月。患者满意度、造口和尿道控尿率分别为 98.7%（n=51）、94.1%（n=48）和 80.4%（n=41）。手术对一般 QOL 和自主能力的影响是强烈而积极的（分别为 4.8 和 4.7 的平均评分，范围为 1 到 5）。总体尿控 Qualiveen QOL 评分为 0.8（0-2.67），表明尿控障碍对 QOL 的负面影响较低。在<45 岁的患者中，52.6%（n=10）报告术后性健康有中度至重要改善。随访期间肾功能保持稳定。
长期来看，连续膀胱造口术和膀胱扩大术为大多数患者提供了极大的满意度。它对一般和特定的尿控 QOL、患者的自主能力和尿控有强烈的积极影响。在年轻患者中，性健康也有积极影响。这些令人鼓舞的数据需要进一步证实，为神经患者提供了有价值的信息，帮助他们决定是否愿意接受连续膀胱造口术。
