Summary:
Continent urinary reservoirs are no longer surgical curiosities. but serious options
replacin the incontinent conduit as the standard urinary diversion. Now that the frequency
of specific complications diminishes with increasing experience the surgeon has to
focus on the psychologic and social aspects of his treatment. In a retrospective study
we investigated, whether continent diversion and wet urostomy disclose significant
differences as to their impact on the patients' quality of life. For this purpose
we developed an instrument based on a biopsychosocial model of disease. The questionnaire
(102 items) was mailed to 600 patients with ileal conduits from all over Germany and
to 130 of our own patients with ileocecal reservoirs. The sample included in the final
analysis was restricted to those patients treated within the last five years (n= 192).
The analysis did not reveal significant differences between the two groups concerning
disease-related support and quality of life when expressed by means of the constructed
instrument (total score). However, a statistically significant superiority of continent
urinary diversion was found wiith regard to all the stoma related items and the patient's
global self-assessment of their quality of line (single item) (p < 0,005), reflecting
the subjective dimension of the concept. Superiority in self-ratings of physical strength,
mental capacity, leisure time activities and social competence (p < 0,05) could be
interpreted as indicators of vital power in patients with continent urinary diversion
and thus supports our understanding that especially young women and men do have a
benefit from continent reservoirs.
Key words:
Quality of life - Cystectomy - Urinary diversion
