Continent Diversion: QOL of Orthotopic Diversion vs. Ileal Conduit View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2009-05-19

AUTHORS

Scott M. Gilbert , Cheryl T. Lee

ABSTRACT

The attendant requirement of urinary diversion following radical cystectomy results in several functional consequences that impact health-related quality of life (HRQOL) in bladder cancer patients managed with surgery. While significant developments in urinary reconstruction have increased the availability of several different forms of continent diversion, the majority of cystectomy patients still receive an incontinent urinary reconstruction. Many surgeons argue, that improved techniques have resulted in reduced complications from continent urinary diversion, and that these types of reconstruction offer better functional and health-related quality of life outcomes compared to incontinent diversion. Certainly, this premise holds intuitive validity; however, this has not been demonstrated reliably to date. While research aimed to address the relative benefit of continent urinary diversion from the perspective of functional outcomes and HRQOL has been an active area of investigation for many years, limitations in methodology and a lack of reliable disease-specific instruments to measure these outcomes have resulted in a lack of progress. To date, high-quality evidence indicating that one type of urinary diversion is superior to another does not exist. Addressing issues related to problematic measurement and improving the quality of research are imperatives to moving the field forward. Currently, there are several disease-specific instruments in various stages of development and testing. A validation of these measures, and systematic assessment of HRQOL will inform the debate regarding the optimal type of urinary diversion. More... »

PAGES

190-199

Book

TITLE

Bladder Cancer

ISBN

978-1-58829-988-8
978-1-59745-417-9

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-1-59745-417-9_19

DOI

http://dx.doi.org/10.1007/978-1-59745-417-9_19

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1000516494


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55 schema:description The attendant requirement of urinary diversion following radical cystectomy results in several functional consequences that impact health-related quality of life (HRQOL) in bladder cancer patients managed with surgery. While significant developments in urinary reconstruction have increased the availability of several different forms of continent diversion, the majority of cystectomy patients still receive an incontinent urinary reconstruction. Many surgeons argue, that improved techniques have resulted in reduced complications from continent urinary diversion, and that these types of reconstruction offer better functional and health-related quality of life outcomes compared to incontinent diversion. Certainly, this premise holds intuitive validity; however, this has not been demonstrated reliably to date. While research aimed to address the relative benefit of continent urinary diversion from the perspective of functional outcomes and HRQOL has been an active area of investigation for many years, limitations in methodology and a lack of reliable disease-specific instruments to measure these outcomes have resulted in a lack of progress. To date, high-quality evidence indicating that one type of urinary diversion is superior to another does not exist. Addressing issues related to problematic measurement and improving the quality of research are imperatives to moving the field forward. Currently, there are several disease-specific instruments in various stages of development and testing. A validation of these measures, and systematic assessment of HRQOL will inform the debate regarding the optimal type of urinary diversion.
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