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Urinary diversion (UD) is required when the bladder must be removed due to bladder cancer, prostate cancer, or treatment of adjacent cancers. Removal of the bladder or radical cystectomy requiring the creation of a UD using a segment of bowel can negatively impact patient quality of life (QOL). Understanding the QOL issues patients with UD face can provide valuable information for wound ostomy continence nurse (WOCN) in supporting the patient treatment decisions, long-term adjustment and rehabilitation.
Purpose:
This descriptive study will describe QOL concerns among cancer patients with UD both continent and incontinent.
Methodology: The newly validated COH-QOL-Ostomy Questionnaire was mailed to a large population of cancer and non-cancer patients with UD at three institutions within the state of
Statistical analyses were conducted using the JMP Statistical Discovery Software, version 4.0.0 final candidate 11, created by SAS Institute (SAS Institute Inc., Carey, NC) All P values were two-sided, with a = 0.05.
Results
The mailing was sent to 2890 individuals with ostomies and 1600 were returned for a 59% response rate; of these, 307 had a UD. The majority of the respondents had bladder or prostate cancer. Average age was 74 and 68.4% were male. Average time since surgery was 9.5 years. Feeling comfortable with daily care took months for most patients. Sexual activity after surgery was reduced for men with 44% reporting problems with erection. Men reported higher interference with personal relationships and intimacy. Women reported lower feelings of control and more fear of recurrence. Continent UD patients tended to be younger and reported greater fear of recurrence. Incontinent UD patients were more likely have difficulties managing daily care and to belong to an ostomy support group.
Conclusions
Ongoing support of UD survivors warrants greater attention and further research.