Impact on quality of life and sexual satisfaction of continent cystostomy with enterocystoplasty in an adult neurologic population

Neurourol Urodyn. 2018 Apr;37(4):1405-1412. doi: 10.1002/nau.23461. Epub 2018 Feb 21.

Abstract

Aims: To evaluate long-term general and urinary quality of life (QOL) and sexual satisfaction in adult neurologic patients undergoing continent cystostomy surgery associated with a bladder enlargement to treat neurogenic lower urinary tract dysfunction.

Methods: Monocentre, retrospective series of adult neurologic patients who underwent continent cystostomy with bladder enlargement and followed-up in the long-term. We assessed during follow-up, urinary and renal function and patients filled QOL questionnaires on general QOL, sexuality and urinary (short form Qualiveen) disability.

Results: Fifty-three patients were included and followed-up 77 months on average. Rates of patients' satisfaction, stomal and urethral continences were respectively of 98.7% (n = 51), 94.1% (n = 48), and 80.4% (n = 41). Impact of surgery on general QOL and autonomy were strong and positive (respective mean scores of 4.8 and 4.7 on a scale ranging from 1 to 5). Mean overall urinary Qualiveen QOL score was 0.8 (0.09-2.67) indicating a low negative impact of urinary disability on QOL. In patients <45 years, 52.6% (n = 10) reported a moderate to important improvement of their sexuality after surgery. Renal function remained stable during follow-up.

Conclusion: In the long-term, continent cystostomy with bladder enlargement provides great satisfaction to almost most patients. It has a strong positive impact on general and specific urinary QOL, patients' autonomy and urinary continence. In young patients a positive impact on sexuality was also noticed. These encouraging data, that need to be confirmed, constitute interesting information to provide to neurologic patients to help them deciding whether they are willing to undergo continent cystostomy surgery.

Keywords: adult population; continent cystostomy; lower urinary tract dysfunction; neurogenic; quality of life; qualiveen.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anastomosis, Surgical / psychology*
  • Cystostomy / psychology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Personal Satisfaction*
  • Quality of Life / psychology*
  • Retrospective Studies
  • Sexual Behavior / psychology*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Urethra / surgery
  • Urinary Bladder, Neurogenic / psychology
  • Urinary Bladder, Neurogenic / surgery*
  • Young Adult