Tuesday, 21 June 2011

Impact on QoL of cystectomy with ileal conduit urinary diversion for neurogenic bladder dysfunction

Guillotreau et al. Neurourol Urodyn. 2011 Jun 14. doi: 10.1002/nau.21121. [Epub ahead of print]

Bladder dysfunction in MS has a negative impact on QoL. Removal of the bladder (cystectomy) with the insertion of a piece of bowel, or ileal conduit, to divert the urine flow into a bag is a treatment option in PwMS who fail conservative treatment. This study evaluated the impact of ileal conduit urinary diversion on the QoL in people with neurogenic bladder dysfunction. Methods: QoL was assessed by self-administered questionnaire scores before and after surgery. Results: After surgery, subjects had a significant reduction in limitations and constraints. There was no significant change in SF36 scores, QoL measure, postoperatively. Conclusions: Ileal conduit urinary diversion improves the urinary QoL of patients with neurogenic bladder dysfunction by decreasing limitations and constraints induced by urinary disorders, but has no impact on general QoL. 


"Another QoL study; I blogged this to say that QoL data is important when making the case to Commissioners about the need for these sorts of operations. Fortunately, urinary diversion procedures are seldom necessary these days, but when they are rarely done they have a big impact on the quality of someone's life. We need to remember this!"


CoI: Nil.

2 comments:

  1. I hope just as convincing QoL arguments are made to N.I.C.E. when it comes to licensing Fampridine.

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  2. Prof G,

    This sort of article is what differentiates the medics from the patients. Whilst medics might view this intervention as a plus / improving 'Quality of Life', as a patient the idea that you have your bladder cut out and live with a bag is nightmare on elmstreet. Quality of life for me is about being independent, working, walking etc - my definition doesn't include any benefits from this intervenetion. It has clarified my thoguths on when to book the one way ticket to Switzerland. The more I hear about this disease, the more vile it becomes. I'd need to be out of heree before my dignitity is completely eradicated by the disease (hopfully a good few years yet).

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