[Patients' Acceptance of Urinary Diversion. The Pouch of Sisyphus]

Overview

Journal Urologe A

Specialty Urology

Date 2012 Mar 16

PMID 22419011

Authors

F-C von Rundstedt

S Roth

C R J Woodhouse

W Mansson

E W Gerharz

Affiliations

Soon will be listed here.

Abstract

It is important that any patient with a urinary diversion can accept the psychological impact alongside the surgical and physical aspects. However, there are currently no validated methods or instruments available to allow direct measurement of this phenomenon in these patients. Health-related quality of life (HRQoL) is often high following different types of urinary diversion-this may suggest a high acceptance level and thus may act as a secondary end point. Such an assessment is a retrospective validation of successful patient selection, allowing us to redirect the nihilistic misinterpretation that urologists should return to offering ileal conduits as a standard. In modern urinary diversion, high patient acceptance develops from comprehensive counselling providing a realistic expectation, careful patient-to-method-matching, strict adherence to surgical detail during the procedure and a meticulous lifelong follow-up. Coping strategies, disease-related social support and confidence in the success of treatment are among other factors which contribute to acceptance of urinary reconstruction as either independent or combined factors. Significant experience is required in every respect, as misjudgement and mistakes in any of these issues may be detrimental to the patients' health. It should be acknowledged that there is no 'best' urinary diversion in general terms. A reconstructive surgeon must have all techniques available and choices need to be tailored to the individual patient.

References

Thulin H, Kreicbergs U, Onelov E, Ahlstrand C, Carringer M, Holmang S . Defecation disturbances after cystectomy for urinary bladder cancer. BJU Int. 2010; 108(2):196-203. DOI: 10.1111/j.1464-410X.2010.09815.x. View

Aaronson N, Sprangers M . [Measuring quality of life in every oncological patient]. Ned Tijdschr Geneeskd. 2011; 155(45):A3749. View

Hunt S . The problem of quality of life. Qual Life Res. 1997; 6(3):205-12. DOI: 10.1023/a:1026402519847. View

Stenzl A, Cowan N, De Santis M, Kuczyk M, Merseburger A, Ribal M . Treatment of muscle-invasive and metastatic bladder cancer: update of the EAU guidelines. Eur Urol. 2011; 59(6):1009-18. DOI: 10.1016/j.eururo.2011.03.023. View

Else-Quest N, Loconte N, Schiller J, Hyde J . Perceived stigma, self-blame, and adjustment among lung, breast and prostate cancer patients. Psychol Health. 2010; 24(8):949-64. DOI: 10.1080/08870440802074664. View

Kulaksizoglu H, Toktas G, Kulaksizoglu I, Aglamis E, Unluer E . When should quality of life be measured after radical cystectomy?. Eur Urol. 2002; 42(4):350-5. DOI: 10.1016/s0302-2838(02)00351-2. View

Gerharz E, Emberton M . Quality of life research in urology. World J Urol. 1999; 17(4):191-2. DOI: 10.1007/s003450050131. View

Gerharz E, Mansson A, Mansson W . Quality of life in patients with bladder cancer. Urol Oncol. 2005; 23(3):201-7. DOI: 10.1016/j.urolonc.2005.03.005. View

Mansson A, Christensson P, Johnson G, COLLEEN S . Can preoperative psychological defensive strategies, mood and type of lower urinary tract reconstruction predict psychosocial adjustment after cystectomy in patients with bladder cancer?. Br J Urol. 1998; 82(3):348-56. DOI: 10.1046/j.1464-410x.1998.00763.x. View

10.

Mansson A, Mansson W . When the bladder is gone: quality of life following different types of urinary diversion. World J Urol. 1999; 17(4):211-8. DOI: 10.1007/s003450050135. View

11.

Horowitz M, Kuhr C, Mitchell M . The Mitrofanoff catheterizable channel: patient acceptance. J Urol. 1995; 153(3 Pt 1):771-2. View

12.

Dutta S, Chang S, Coffey C, Smith Jr J, Jack G, Cookson M . Health related quality of life assessment after radical cystectomy: comparison of ileal conduit with continent orthotopic neobladder. J Urol. 2002; 168(1):164-7. View

13.

Wright J, Porter M . Quality-of-life assessment in patients with bladder cancer. Nat Clin Pract Urol. 2007; 4(3):147-54. DOI: 10.1038/ncpuro0750. View

14.

Hamidou Z, Dabakuyo T, Bonnetain F . Impact of response shift on longitudinal quality-of-life assessment in cancer clinical trials. Expert Rev Pharmacoecon Outcomes Res. 2011; 11(5):549-59. DOI: 10.1586/erp.11.57. View

15.

Mansson A, Caruso A, Capovilla E, COLLEEN S, Bassi P, Pagano F . Quality of life after radical cystectomy and orthotopic bladder substitution: a comparison between Italian and Swedish men. BJU Int. 2000; 85(1):26-31. DOI: 10.1046/j.1464-410x.2000.00416.x. View

16.

Bussing A, Fischer J . Interpretation of illness in cancer survivors is associated with health-related variables and adaptive coping styles. BMC Womens Health. 2009; 9:2. PMC: 2661070. DOI: 10.1186/1472-6874-9-2. View

17.

Herschbach P . [The "Well-being paradox" in quality-of-life research]. Psychother Psychosom Med Psychol. 2002; 52(3-4):141-50. DOI: 10.1055/s-2002-24953. View

18.

Henningsohn L, Steven K, Kallestrup E, Steineck G . Distressful symptoms and well-being after radical cystectomy and orthotopic bladder substitution compared with a matched control population. J Urol. 2002; 168(1):168-74; discussion 174-5. DOI: 10.1016/s0022-5347(05)64854-9. View

19.

Bakke A, Jensen K, Jonsson O, Jonsson E, Mansson W, Paananen I . The rationale behind recommendations for follow-up after urinary diversion: an evidence-based approach. Scand J Urol Nephrol. 2007; 41(4):261-9. DOI: 10.1080/00365590600991284. View

20.

Gerharz E, Weingartner K, Dopatka T, Kohl U, Basler H, Riedmiller H . Quality of life after cystectomy and urinary diversion: results of a retrospective interdisciplinary study. J Urol. 1997; 158(3 Pt 1):778-85. DOI: 10.1097/00005392-199709000-00023. View