Skip to main content
Erschienen in: World Journal of Urology 1/2014

01.02.2014 | Original article

Urinary functional outcomes in female neobladder patients

verfasst von: Georg Bartsch, Siamak Daneshmand, Eila C. Skinner, Sumeet Syan, Donald G. Skinner, David F. Penson

Erschienen in: World Journal of Urology | Ausgabe 1/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The ratio between orthotopic and non-orthotopic diversions in women is far lower than in male patients. Data on urinary function in female patients with neobladders are therefore sparse.

Methods

We investigated the urinary function of female neobladder patients utilizing the Bladder Cancer Index, a validated and reliable health-related quality-of-life (HRQOL) questionnaire. Furthermore, we tried to identify preoperative factors that may influence functional results. All living female patients with an orthotopic neobladder (N = 82) from the University of Southern California Bladder Cancer Database were sent a questionnaire including the University of Michigan Bladder Cancer Index. Univariate analyses were performed using the Kruskal–Wallis test followed by a multivariate stepwise regression model.

Results

Fifty-six patients (68.3 %) responded and were included in the analysis. Thirty-five (62.5 %) of these patients had to catheterize their neobladder to a certain amount, while 25 patients (44.6 %) depend on catheterization to empty their neobladder. Univariate analyses showed that patient age (>65 years) was the only variable associated with a statistically significant lower rate of neobladder catheterization. Better urinary bother scores were associated with organ-confined disease (p = 0.038) and education level (p = 0.01). However, these variables were not significant in a multivariate stepwise linear regression model.

Conclusion

Considerably more women require urinary catheterization to void than previously reported. In this study, representing the largest investigated cohort in this topic, we were unable to identify any predictors of this outcome or any other urinary HRQOL in this cohort.
Literatur
1.
Zurück zum Zitat Yossepowitch O, Dalbagni G, Golijanin D, Donat SM, Bochner BH, Herr HW, Fair WR, Russo P (2003) Orthotopic urinary diversion after cystectomy for bladder cancer: implications for cancer control and patterns of disease recurrence. J Urol 169(1):177–181PubMedCrossRef Yossepowitch O, Dalbagni G, Golijanin D, Donat SM, Bochner BH, Herr HW, Fair WR, Russo P (2003) Orthotopic urinary diversion after cystectomy for bladder cancer: implications for cancer control and patterns of disease recurrence. J Urol 169(1):177–181PubMedCrossRef
2.
Zurück zum Zitat Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S, Skinner E, Bochner B, Thangathurai D, Mikhail M, Raghavan D, Skinner DG (2001) Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol 19(3):666–675PubMed Stein JP, Lieskovsky G, Cote R, Groshen S, Feng AC, Boyd S, Skinner E, Bochner B, Thangathurai D, Mikhail M, Raghavan D, Skinner DG (2001) Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol 19(3):666–675PubMed
3.
4.
Zurück zum Zitat Hobisch A, Tosun K, Kinzl J, Kemmler G, Bartsch G, Holtl L, Stenzl A (2001) Life after cystectomy and orthotopic neobladder versus ileal conduit urinary diversion. Semin Urol Oncol 19(1):18–23PubMed Hobisch A, Tosun K, Kinzl J, Kemmler G, Bartsch G, Holtl L, Stenzl A (2001) Life after cystectomy and orthotopic neobladder versus ileal conduit urinary diversion. Semin Urol Oncol 19(1):18–23PubMed
5.
Zurück zum Zitat Fujisawa M, Isotani S, Gotoh A, Okada H, Arakawa S, Kamidono S (2000) Health-related quality of life with orthotopic neobladder versus ileal conduit according to the SF-36 survey. Urology 55(6):862–865PubMedCrossRef Fujisawa M, Isotani S, Gotoh A, Okada H, Arakawa S, Kamidono S (2000) Health-related quality of life with orthotopic neobladder versus ileal conduit according to the SF-36 survey. Urology 55(6):862–865PubMedCrossRef
6.
Zurück zum Zitat Salinas Sanchez AS, Segura Martin M, Lorenzo Romero JG, Hernandez Millan I, Fernandez Olano C, Virseda Rodriguez JA (2001) Quality of life of patients after radical surgery of bladder cancer. Arch Esp Urol 54(8):787–795PubMed Salinas Sanchez AS, Segura Martin M, Lorenzo Romero JG, Hernandez Millan I, Fernandez Olano C, Virseda Rodriguez JA (2001) Quality of life of patients after radical surgery of bladder cancer. Arch Esp Urol 54(8):787–795PubMed
7.
Zurück zum Zitat Dutta SC, Chang SC, Coffey CS, Smith JA Jr, Jack G, Cookson MS (2002) Health related quality of life assessment after radical cystectomy: comparison of ileal conduit with continent orthotopic neobladder. J Urol 168(1):164–167PubMedCrossRef Dutta SC, Chang SC, Coffey CS, Smith JA Jr, Jack G, Cookson MS (2002) Health related quality of life assessment after radical cystectomy: comparison of ileal conduit with continent orthotopic neobladder. J Urol 168(1):164–167PubMedCrossRef
8.
Zurück zum Zitat Daneshmand S, Bartsch G (2011) Improving selection of appropriate urinary diversion following radical cystectomy for bladder cancer. Expert Rev Anticancer Ther 11(6):941–948PubMedCrossRef Daneshmand S, Bartsch G (2011) Improving selection of appropriate urinary diversion following radical cystectomy for bladder cancer. Expert Rev Anticancer Ther 11(6):941–948PubMedCrossRef
9.
Zurück zum Zitat Gilbert SM, Wood DP, Dunn RL, Weizer AZ, Lee CT, Montie JE, Wei JT (2007) Measuring health-related quality of life outcomes in bladder cancer patients using the Bladder Cancer Index (BCI). Cancer 109(9):1756–1762PubMedCrossRef Gilbert SM, Wood DP, Dunn RL, Weizer AZ, Lee CT, Montie JE, Wei JT (2007) Measuring health-related quality of life outcomes in bladder cancer patients using the Bladder Cancer Index (BCI). Cancer 109(9):1756–1762PubMedCrossRef
10.
Zurück zum Zitat Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376PubMedCrossRef Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85(5):365–376PubMedCrossRef
11.
Zurück zum Zitat Cookson MS, Dutta SC, Chang SS, Clark T, Smith JA Jr, Wells N (2003) Health related quality of life in patients treated with radical cystectomy and urinary diversion for urothelial carcinoma of the bladder: development and validation of a new disease specific questionnaire. J Urol 170(5):1926–1930PubMedCrossRef Cookson MS, Dutta SC, Chang SS, Clark T, Smith JA Jr, Wells N (2003) Health related quality of life in patients treated with radical cystectomy and urinary diversion for urothelial carcinoma of the bladder: development and validation of a new disease specific questionnaire. J Urol 170(5):1926–1930PubMedCrossRef
12.
Zurück zum Zitat Cella D, Neubauer N, Thomas J, Kutner J, Seiden MV (2013) The FACIT-AI, a new tool for assessing symptoms associated with malignant ascites. Gynecol Oncol 128(2):187–190PubMedCrossRef Cella D, Neubauer N, Thomas J, Kutner J, Seiden MV (2013) The FACIT-AI, a new tool for assessing symptoms associated with malignant ascites. Gynecol Oncol 128(2):187–190PubMedCrossRef
13.
Zurück zum Zitat Stein JP, Penson DF, Lee C, Cai J, Miranda G, Skinner DG (2009) Long-term oncological outcomes in women undergoing radical cystectomy and orthotopic diversion for bladder cancer. J Urol 181(5):2052–2058PubMedCrossRef Stein JP, Penson DF, Lee C, Cai J, Miranda G, Skinner DG (2009) Long-term oncological outcomes in women undergoing radical cystectomy and orthotopic diversion for bladder cancer. J Urol 181(5):2052–2058PubMedCrossRef
14.
Zurück zum Zitat Schrier BP, Laguna MP, van der Pal F, Isorna S, Witjes JA (2005) Comparison of orthotopic sigmoid and ileal neobladders: continence and urodynamic parameters. Eur Urol 47(5):679–685PubMedCrossRef Schrier BP, Laguna MP, van der Pal F, Isorna S, Witjes JA (2005) Comparison of orthotopic sigmoid and ileal neobladders: continence and urodynamic parameters. Eur Urol 47(5):679–685PubMedCrossRef
15.
Zurück zum Zitat Stein JP, Skinner DG (2006) Radical cystectomy for invasive bladder cancer: long-term results of a standard procedure. World J Urol 24(3):296–304PubMedCrossRef Stein JP, Skinner DG (2006) Radical cystectomy for invasive bladder cancer: long-term results of a standard procedure. World J Urol 24(3):296–304PubMedCrossRef
16.
Zurück zum Zitat Hautmann RE, Volkmer BG, Schumacher MC, Gschwend JE, Studer UE (2006) Long-term results of standard procedures in urology: the ileal neobladder. World J Urol 24(3):305–314PubMedCrossRef Hautmann RE, Volkmer BG, Schumacher MC, Gschwend JE, Studer UE (2006) Long-term results of standard procedures in urology: the ileal neobladder. World J Urol 24(3):305–314PubMedCrossRef
17.
Zurück zum Zitat Lee LJ, Chen CH, Yao G, Chung CW, Sheu JC, Lee PH, Tsai YJ, Wang JD (2007) Quality of life in patients with hepatocellular carcinoma received surgical resection. J Surg Oncol 95(1):34–39PubMedCrossRef Lee LJ, Chen CH, Yao G, Chung CW, Sheu JC, Lee PH, Tsai YJ, Wang JD (2007) Quality of life in patients with hepatocellular carcinoma received surgical resection. J Surg Oncol 95(1):34–39PubMedCrossRef
18.
Zurück zum Zitat Ahmadi H, Skinner EC, Simma-Chiang V, Miranda G, Cai J, Penson DF, Daneshmand S (2013) Urinary functional outcome following radical cystoprostatectomy and ileal neobladder reconstruction in male patients. J Urol 189(5):1782–1788PubMedCrossRef Ahmadi H, Skinner EC, Simma-Chiang V, Miranda G, Cai J, Penson DF, Daneshmand S (2013) Urinary functional outcome following radical cystoprostatectomy and ileal neobladder reconstruction in male patients. J Urol 189(5):1782–1788PubMedCrossRef
19.
Zurück zum Zitat Granberg CF, Boorjian SA, Crispen PL, Tollefson MK, Farmer SA, Frank I, Blute ML (2008) Functional and oncological outcomes after orthotopic neobladder reconstruction in women. BJU Int 102(11):1551–1555PubMedCrossRef Granberg CF, Boorjian SA, Crispen PL, Tollefson MK, Farmer SA, Frank I, Blute ML (2008) Functional and oncological outcomes after orthotopic neobladder reconstruction in women. BJU Int 102(11):1551–1555PubMedCrossRef
20.
Zurück zum Zitat Park JM, Montie JE (1998) Mechanisms of incontinence and retention after orthotopic neobladder diversion. Urology 51(4):601–609PubMedCrossRef Park JM, Montie JE (1998) Mechanisms of incontinence and retention after orthotopic neobladder diversion. Urology 51(4):601–609PubMedCrossRef
21.
Zurück zum Zitat Bhatta Dhar N, Kessler TM, Mills RD, Burkhard F, Studer UE (2007) Nerve-sparing radical cystectomy and orthotopic bladder replacement in female patients. Eur Urol 52(4):1006–1014PubMedCrossRef Bhatta Dhar N, Kessler TM, Mills RD, Burkhard F, Studer UE (2007) Nerve-sparing radical cystectomy and orthotopic bladder replacement in female patients. Eur Urol 52(4):1006–1014PubMedCrossRef
22.
Zurück zum Zitat Kessler TM, Studer UE, Burkhard FC (2007) Increased proximal urethral sensory threshold after radical pelvic surgery in women. Neurourol Urodyn 26(2):208–212PubMedCrossRef Kessler TM, Studer UE, Burkhard FC (2007) Increased proximal urethral sensory threshold after radical pelvic surgery in women. Neurourol Urodyn 26(2):208–212PubMedCrossRef
23.
Zurück zum Zitat Simon J, Bartsch G Jr, Kufer R, Gschwend JE, Volkmer BG, Hautmann RE (2006) Neobladder emptying failure in males: incidence, etiology and therapeutic options. J Urol 176(4 Pt 1):1468–1472PubMedCrossRef Simon J, Bartsch G Jr, Kufer R, Gschwend JE, Volkmer BG, Hautmann RE (2006) Neobladder emptying failure in males: incidence, etiology and therapeutic options. J Urol 176(4 Pt 1):1468–1472PubMedCrossRef
24.
Zurück zum Zitat Kubler H, Gschwend JE (2011) Ileal neobladder in women with bladder cancer: cancer control and functional aspects. Curr Opin Urol 21(6):478–482PubMedCrossRef Kubler H, Gschwend JE (2011) Ileal neobladder in women with bladder cancer: cancer control and functional aspects. Curr Opin Urol 21(6):478–482PubMedCrossRef
Metadaten
Titel
Urinary functional outcomes in female neobladder patients
verfasst von
Georg Bartsch
Siamak Daneshmand
Eila C. Skinner
Sumeet Syan
Donald G. Skinner
David F. Penson
Publikationsdatum
01.02.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 1/2014
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-013-1219-8

Weitere Artikel der Ausgabe 1/2014

World Journal of Urology 1/2014 Zur Ausgabe

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.