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Functional outcome of orthotopic bladder substitution: a comparison between the S-shaped and U-shaped neobladder
Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0003-4615-5238
Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0002-9062-8840
Örebro University Hospital, Örebro, Sweden.
2010 (English)In: Scandinavian Journal of Urology and Nephrology, ISSN 0036-5599, E-ISSN 1651-2065, Vol. 44, no 4, p. 197-203Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To compare the functional outcome of two types of orthotopic bladder substitution, the S-shaped and the U-shaped neobladder, with respect to leakage, functional capacity and quality of life.

MATERIAL AND METHODS: Between 1999 and 2007, 45 male patients with urinary bladder cancer were treated with cystectomy and orthotopic bladder substitution; 23 with the S-shaped bladder ad modum Schreiter and 22 with the U-shaped bladder ad modum Studer. Patients were followed up by a urologist and a specialized nurse (urotherapist) at 1, 3 and 6 months. At each visit the patient completed a voiding chart, a weighted pad test and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Differences between the groups in functional outcome and quality of life variables were analysed by Student's t test using SPSS software.

RESULTS: Mean maximum bladder capacity increased over time. At 6 months, the S-bladder had a larger capacity than the U-bladder (525 ml vs 423 ml). Patients with an S-bladder had less urine leakage at all follow-ups, although this was statistically significant only at 6 months regarding day-time incontinence and at all visits regarding night-time incontinence. The mean urine leakage at 6 months was 7 g (day) and 30 g (night) in the S-bladder group and 50 g (day) and 250 g (night) in the U-bladder group. However, quality of life did not differ between the groups.

CONCLUSION: The S-bladder had better bladder capacity and less leakage than the U-bladder, but these differences did not translate into differences in quality of life. The results should be confirmed in larger prospective studies.

Place, publisher, year, edition, pages
Taylor & Francis, 2010. Vol. 44, no 4, p. 197-203
Keywords [en]
Functional outcome, neobladder, orthotopic bladder substitution, quality of life, urinary leakage
National Category
Urology and Nephrology Nursing
Research subject
Medicine; Nursing Science
Identifiers
URN: urn:nbn:se:oru:diva-35176DOI: 10.3109/00365591003727577ISI: 000282143600001PubMedID: 20367221Scopus ID: 2-s2.0-77955538348OAI: oai:DiVA.org:oru-35176DiVA, id: diva2:719819
Available from: 2014-05-27 Created: 2014-05-27 Last updated: 2019-04-09Bibliographically approved
In thesis
1. Clinical aspects of cystectomy and urinary diversion
Open this publication in new window or tab >>Clinical aspects of cystectomy and urinary diversion
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to explore different aspects of treatment of advanced urinary bladder cancer with radical cystectomy, pelvic lymph node dissection, and urinary diversion. Surgery that carry a high risk of complications as well as mortality. Aside from complications and risk of recurrance, patients have to cope with lifelong postoperative changes of body function, including sexual function, and body image, all affecting quality of life (QoL). The thesis comprises four papers. In the first paper, we compared functional outcome and QoL following two types of ileal orthotopic neobladder substitution. The results suggest that the S-shaped substitute entails better functional results than the U-shaped substitute, with better continence, especially at night. There was no difference in QoL. The second paper reports results from the first year of registration in the nation-wide Swedish Cystectomy Register. Analysis of risk factors for complications showed that high age and prolonged operation are associated with increased risk of short-term complications. The third paper investigated whether preoperative chemotherapy in patients with muscle-invasive bladder cancer (MIBC) affects the risk of shortterm complications after radical cystectomy, using data from the Cystectomy Register covering 1340 patients of whom 39 percent received preoperativevchemotherapy. We found no such increase in risk. In the fourth paper, we analysed the results of a validation study of the Cystectomy Register. The validation showed 17 percent more low grade complications, three percent more high grade complications, and five percent more readmissions, within 90 days of surgery. Hence, a third-party validation may improve the validity of the register

Place, publisher, year, edition, pages
Örebro: Örebro University, 2019. p. 91
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 190
Keywords
Bladder cancer, urinary diversion, orthotopic neobladder substitution, postoperative complications, neoadjuvant chemotherapy, induction chemotherapy
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-72379 (URN)978-91-7529-275-5 (ISBN)
Public defence
2019-04-26, Örebro universitet, Campus USÖ, hörsal C3, Södra Grev Rosengatan 32, Örebro, 09:00 (English)
Opponent
Supervisors
Available from: 2019-02-11 Created: 2019-02-11 Last updated: 2019-04-10Bibliographically approved

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Jerlström, TomasAndersson, Gunnel

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