Prospective evaluation of quality-of-life outcomes following orthotopic neobladder and ileal conduit diversion after radical cystectomy

Objective: The aim of this study was to evaluate health-related quality of life outcomes in patients who underwent orthotopic neobladder reconstruction (ONB) or ileal conduit (IC). Patients: Eight centers participated in this prospective study that included consecutive patients planned for radical cystectomy. Patients were asked to choose between IC or ONB reconstruction after thorough information. They had to complete the validated self-administered Bladder Cancer Index (BCI) preoperatively and again at 6 and 12 months after surgery as well as a set of questions exploring body image. Results: Among 106 patients who were invited to participate, 73 completed the preoperative questionnaires. In the preoperative phase, there were no significant differences in any of the QoL domains. At 6 months, 58 (61%) patients completed their questionnaires showing better functional scores in favor of IC in the urinary domain (P= 0.01). There was no other difference between groups. At 12 months, the findings were similar to those of the 6th month except for body image that was more favorable in ONB patients. VAS assessing diversion overall satisfaction was excellent in both groups despite a poor sexual satisfaction. Conclusions: Even if the results of this prospective non randomized study reflect partly the age difference between groups, they showed a better body image in ONB patients but a better urinary control for IC patients. In both groups, conversely to overall self-assessed satisfaction, sexual satisfaction was poor. *Correspondence to: Jacques Irani, Department of Urology, University Hospital of BICETRE, 94270 Le Kremlin-Bicetre, France, E-mail: jacques.irani@aphp.fr