CLINICAL FEATURE AND QUALITY OF LIFE OF URINARY DIVERSION PATIENTS WITH BLADDER CANCER

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Abstract
A clinical survey was performed on 95 cases who were treated by total cystectomy with urinary diversion at our hospital between August 1971 and March 1992. Urinary diversions were classified by ureterocutaneostomy (Group I) in 27 patients, ileal or colon conduit (Group II) in 45 and continent urinary reservoir (Group III) in 23. The patients ranged in age from 29 to 76 with an average age of 60.6 year and the male to female ratio was 68 to 27. Histopathological typing of bladder cancers showed 82 cases of transitional cell carcinoma, 8 cases of squamous cell carcinoma, 4 cases of adenocarcinoma, and 1 mixed carcinoma with transitional cell carcinoma, squamous cell carcinoma and adenocarcinoma. At present, patients alive of Group I, II and III were 14, 27 and 16, respectively, totally 57 (60.0%) patients were alive. Five-year actuarial survival rates of Group I, II and III were 45.2%, 54.1%, and 56.8%, respectively. A questionnaire survey was carried out to assess the quality of life (QOL) of 57 alive patients. The analysis of replied questionnaire showed that even all patients of each groups adapted to the basic life activities after urinary diversion, though a step forward quality of life with hobby, travel and job were decreased postoperatively in 3 groups. We obtained results that the patients of Group III were more satisfactory with daily (bath) and social life (job) than the patients of Group I, II and preoperatively. We have a new comprehension of importance of enough informed consent and mental support to the urinary diversion patients preoperatively, and of a new operative procedure not to impair the QOL.

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