Presentation Authors: Charles Peyton*, Richard Reich, Tampa, FL, Carl Henriksen, Gainsville, FL, Mounsif Azizi, Wade Sexton, Michael Poch, Philippe Spiess, Tampa, FL, Paul Crispen, Gainsville, FL, Scott Gilbert, Tampa, FL
Introduction: Though a morbid surgery, patient-reported deficits and recovery of quality of life (QOL) after cystectomy have not been fully characterized. Prior QOL research after cystectomy is limited by cross-sectional assessment often based on non-specific measures.
Methods: 150 cystectomy patients were accrued to a prospective QOL study from 2014 to 2016 and followed for 1 year after surgery. Study patients completed a series of questionnaires, including the Bladder Cancer Index (BCI), Body Image Scale (BIS) and Medical Outcomes Study Short Form (SF-36) prior to cystectomy and at 3, 6 and 12 months after surgery. Latent growth modeling was used to examine initial differences after cystectomy (conditional intercepts) and changes in score over time (conditional slopes) according to type of urinary diversion and adjusted for pre-surgery differences, age, sex and comorbidity.
Results: Neobladder (NB) patients experienced significant initial deficits in BCI urinary function scores compared to ileal conduit (IC, p < 0.001). Urinary BCI scores remained lower for NB patients from 3-12 months, but scores recovered at a similar rate to those of IC patients. No significant differences were seen for bowel or sexual domains (p>0.05) after cystectomy. Deficits in bowel function were temporary for most patients. Deficits in and partial recovery of sexual function were more pronounced for NB patients. BIS scores were significantly higher (worse body image) for IC patients compared to NB patients (intercept p=0.005) (Figure). IC patients had lower SF-36 general and mental health scores after cystectomy (6.2 and 4.1 points lower, respectively, p < 0.05). SF-36 physical health scores slopes worsened by 1.6 points over time for both IC vs NB patients (p=0.03).
Conclusions: Both NB and IC are associated with notable deficits in function, body image and general health. For example, urinary function was significantly worse and body image was better for NB patients compared to IC patients. General health and quality of life scores were negatively affected after surgery regardless of diversion type. These data better characterize important functional, body image and general health deficits experiences by patients after cystectomy.
Source of Funding: Florida Department of Health, Bankhead Coley Research Program