Department of Urology, Skåne University Hospital, Malmö, Sweden.
Department of Urology, Skåne University Hospital, Malmö, Sweden; Institution of Translational Medicine, Lund University, Malmö, Sweden.
Scand J Urol. 2023 Sep 21;58:76-83. doi: 10.2340/sju.v58.11952.
The aim of this study was to investigate health-related quality of life (HRQoL) before and 1 year after radical cystectomy in relation to age and gender.
This prospective study involves 112 men and 40 women with bladder cancer treated with radical cystectomy between 2015 and 2018. HRQoL was assessed preoperatively and 1 year post-surgery through Functional Assessment of Cancer Therapy Scale - General (FACT-G) and Functional Assessment of Cancer Therapy Scale - Vanderbilt Cystectomy Index (FACT-VCI) questionnaires. The median age of the 152 patients was 71.5 years.
Preoperatively, emotional and functional well-being were negatively affected. Physical, emotional and functional well-being presented higher values 1 year after surgery compared to before radical cystectomy, that is, better HRQoL. Social well-being showed a reduction, especially regarding closeness to partner and support from family. Men and women were equally satisfied with their sex life before radical cystectomy, but less so 1 year after, where men were less satisfied compared to women. Additionally, one out of five patients reported that they had to limit their physical activities, were afraid of being far from a toilet and were dissatisfied with their body appearance after surgery.
Recovery regarding HRQoL was ongoing 1 year after radical cystectomy. Patients recovered in three out of four dimensions of HRQoL, but social well-being was still negatively affected 1 year after treatment. Sexual function after radical cystectomy was exceedingly limited for both men and women. An individual sexual rehabilitation plan involving the couple with special intention to encourage intimacy, might not only improve sexual life but also have a positive effect on social well-being as a consequence.
本研究旨在探讨根治性膀胱切除术前后与年龄和性别相关的健康相关生活质量（HRQoL）。
本前瞻性研究纳入了 2015 年至 2018 年间接受根治性膀胱切除术治疗的 112 名男性和 40 名女性膀胱癌患者。通过癌症治疗功能评估量表-一般（FACT-G）和癌症治疗功能评估量表-范德比尔特膀胱切除术指数（FACT-VCI）问卷，分别在术前和术后 1 年评估 HRQoL。152 例患者的中位年龄为 71.5 岁。
术前，情感和功能健康受到负面影响。与根治性膀胱切除术前相比，术后 1 年患者的身体、情感和功能健康状况均有所改善，即 HRQoL 更好。社会健康状况有所下降，尤其是与伴侣的亲密关系和家庭支持方面。男性和女性在接受根治性膀胱切除术之前对性生活的满意度相同，但术后 1 年的满意度降低，男性的满意度低于女性。此外，五分之一的患者报告说他们不得不限制体力活动，害怕远离厕所，对手术后的身体外观不满意。
根治性膀胱切除术后 1 年，HRQoL 仍在恢复中。患者在 HRQoL 的四个维度中有三个得到了恢复，但社会健康状况在治疗后 1 年仍受到负面影响。根治性膀胱切除术后，男女患者的性功能都受到了极大的限制。制定一个包括伴侣的个体化性功能康复计划，特别关注鼓励亲密关系，不仅可以改善性生活，还可以对社会健康状况产生积极影响。
