Following cystectomy, does a continent diversion provide a higher quality of life than an incontinent diversion?

 

 

Topic:

It has been proposed that the quality of life for patients who undergo cystectomy is influenced by the type of urinary diversion that they receive. Bladder cancer affects thousands of Americans yearly and cystectomy with urinary diversion is the mainstay of treatment for patients with muscle invasive disease. The type of urinary diversion chosen by the patient in concert with the surgeon will have a lasting functional impact on these patients for the rest of their lives. The WOCN can directly impact the patient’s quality of life post surgery by providing educational materials to allow an informed decision.

 

Purpose:

To analyze data on quality of life for patients with cystectomy who have a continent diversion compared to an incontinent diversion. Clinicians presume that a diversion, which replicates the normal voiding pattern, will provide a higher quality of life than a diversion which results in a stoma.

 

Objective:

To develop counseling strategies and education materials for patients undergoing cystectomy that will improve perceived quality of life. As more people are surviving their disease, education can play a key factor in preparing the patient to make an informed decision regarding which type of diversion will result in a positive quality of life. The preoperative and postoperative education by a WOC nurse may improve long term quality of life.

 

Outcomes:

A review of the literature was performed to explore the data available on the reported quality of life of patients with a cystectomy. This information is used in creating standardized education materials for the patient undergoing cystectomy that can be used by the multidisciplinary team. This information is helpful to guide the WOCN to provide individualized counseling to ensure that the outcomes of surgery meet the preoperative expectation.