The Related Factors Of Quality Of Life Among The Patients Who Have Undergone Orthotopic Neobladder Reconstruction After Radical Cystectomy

Objective:To investigate whether demographic information and urodynamic indicators have impact on quality of life (QOL) in bladder cancer patients who have undergone orthotopic neobladder reconstruction after radical cystectomy. We expect to establish an assessment system of quality of life based on urodynamic indicators, which may make a scientific reference for treatment of patients, and improve the quality of life.Methods:We collected data about patients who had diagnosed with bladder cancer as well as underwent orthotopic neobladder reconstruction after successful radical cystectomy in Department of Urology, The Third Hospital of Xiangya, Central South University from October2010to December2012. The patients were suggested to follow-up once every (180±7) days postoperatively. At the six-month postoperative outpatient follow-up, we used EQ-5D (European quality-5D) as assessment tool of quality of life. In addition to routine examinations, urodynamic tests were performed orderly. At last, we conducted a correlation statistical analysis between urodynamic indicators and QOL scores. The indicators consisted of maximum flow rate, maximum cystometric capacity, residual urine volume and maximum urethral pressure.Results:1. Among the58patients, seven patients did not follow-up punctually, one patient died, six patients’data of urodynamic results were not collected, two patients occurred postoperative complications as intestinal obstruction, so42effective cases were collected in all.2. Description of the patients’quality of life:the EQ-VAS score of patients is84.71±9.91, the EQ-5D score is0.86±0.14. 3. Description of the patients’urodynamic:maximum flow rate of42patients were (12.01±6.17) ml/s, the maximum cystometric capacity were (373.5±218.6) ml, the residual urine volume were (59.05±188.9) ml, and the maximum urethral pressure were (76.75±26.79) cm/H2O.4. Univariate analysis:the factors of the patients’quality of life:age, maximum flow rates, complications, rehabilitative training and urinary incontinence5. Multivariate analysis:maximum flow rate, complications and rehabilitative training are the related factors of patients’EQ-VAS score, the coefficient of determination is0.551. As for patients’EQ-5D scores, maximum flow rate, rehabilitative training and urinary incontinence are the related factors, and the coefficient of determination is0.608.Conclusions:The scores of quality of life among the patients after radical cystectomy are satisfying, and the related factors are maximum flow rate, complications, rehabilitative training and urinary incontinence. It shows that patients having better maximum flow rate, participating in rehabilitative training regularly and having not complications and urinary incontinence share higher quality of life.