Bjerre B D, Johansen C, Steven K
Department of Urology, Herlev Hospital, Denmark.
Br J Urol. 1995 Feb;75(2):200-5. doi: 10.1111/j.1464-410x.1995.tb07312.x.
To compare the health-related quality of life after bladder substitution with that following ileal conduit diversion.
Sixty-seven male patients with bladder cancer completed the questionnaire; 38 had undergone bladder substitution and 29 ileal conduit diversion; the median follow-up was 1.0 year (range 0.5-3.0) and 4.8 years (range 1.1-15.2), respectively. Semi-structured qualitative interviews were conducted and analysed, and the questionnaire was developed based upon these results.
Both day- and night-time urinary leakage occurred more frequently following bladder substitution (18% against 10%, and 21% against 3%). Nevertheless, urinary leakage affected conduit patients more severely and they scored higher on a leakage distress scale. Furthermore, 58% of the ileal conduit but only 21% of the bladder substitution patients gave urinary leakage as their main concern (P = 0.04). Ileal conduit patients did not retain their body image as well as those with bladder substitution. The frequency of both sexual and non-sexual physical contacts decreased in the majority of the conduit patients but only in a minority of the bladder substitute patients. Global satisfaction was high and similar in both groups.
These results show that the health-related quality of life is retained to a higher degree after bladder substitution and supports the use of this procedure as the standard method of diversion after cystectomy for bladder cancer.
比较膀胱替代术后与回肠膀胱术式后的健康相关生活质量。
67例男性膀胱癌患者完成了问卷调查；38例行膀胱替代术，29例行回肠膀胱术；中位随访时间分别为1.0年（范围0.5 - 3.0年）和4.8年（范围1.1 - 15.2年）。进行了半结构化定性访谈并分析，基于这些结果制定了问卷。
膀胱替代术后白天和夜间尿失禁发生率均更高（分别为18%对10%，21%对3%）。然而，尿失禁对回肠膀胱术患者影响更严重，他们在尿失禁困扰量表上得分更高。此外，58%的回肠膀胱术患者但仅21%的膀胱替代术患者将尿失禁作为主要担忧（P = 0.04）。回肠膀胱术患者的身体形象不如膀胱替代术患者。大多数回肠膀胱术患者的性接触和非性身体接触频率降低，但膀胱替代术患者中只有少数如此。总体满意度较高且两组相似。
这些结果表明，膀胱替代术后健康相关生活质量在更高程度上得以保留，支持将该术式作为膀胱癌膀胱切除术后标准的尿流改道术式。
