The W-shaped ileal neobladder: Long term functional outcomes and health-related quality of life

• Published in: Progrès en urologie (Paris) Vol. 26; no. 6; p. 367
• Main Authors: Belot, P-Y, Fassi-Fehri, H, Colombel, M, Matillon, X, Crouzet, S, Martin, X, Abid, N, Badet, L
• Format: Journal Article
• Language: French
• Published: France 01-05-2016
• Subjects: Adult; Aged; Follow-Up Studies; Humans; Ileum - surgery; Middle Aged; Quality of Life; Retrospective Studies; Urinary Bladder Neoplasms - surgery; Urinary Diversion - methods; Urinary Reservoirs, Continent; Urodynamics; Continence; Hautmann; Health-related quality of life; Ileal neobladder; Urinary diversion; Functional outcomes; Dérivation urinaire; Néovessie iléale; Qualité de vie; Long term; Résultats fonctionnels; Long terme
• ISSN: 1166-7087
• DOI: 10.1016/j.purol.2016.03.006

To evaluate functional outcomes and patients' health-related quality of life over ten years after a W-shaped ileal neobladder urinary diversion.
From 1994 to 2004, 87 patients with bladder cancer underwent a cystoprostatectomy with a W-shaped ileal neobladder. Among them, 31 patients (35.6%) were evaluated. The average follow-up was 158months, average age was 72years. We assessed functional outcomes (use of protections, USP score, uroflowmetry, postvoid residual volume), overall health-related quality of life (SF-36 score), and specific urinary-related quality of life (Ditrovie scale).
Daytime continence was satisfactory in 29 patients (96.8%). Night-time continence was satisfactory in 27 patients (87.1%). Mean daytime continence, hyperactivity and dysuria scores of the USP were respectively 1.5/9, 3.2/21 and 2/9. Mean value of the maximum flow rate was 18mL/s for an average voiding volume of 324mL and an average postvoid residual volume of 70mL. The 8 dimensions of the SF-36 were all comparable with the French population's values. According to the Ditrovie scale whose average value was 1.83, the health-related quality of life was unchanged or little changed by urinary disorders in 28 patients (90.3%).
Our results suggest that voiding status and health-related quality of life remain satisfactory over ten years after an orthotopic ileal neobladder derivation.
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