Short-term effects of bowel function on global health quality of life after radical cystectomy

Minerva Urol Nephrol. 2024 Aug;76(4):452-457. doi: 10.23736/S2724-6051.24.05730-6. Epub 2024 Jun 5.

Abstract

Background: Radical cystectomy (RC) shows an important impact on quality of life (QoL), for various clinical aspects. The aim of our study was to evaluate the short-term bowel function in patients that underwent RC.

Methods: Two hundred and six patients with MIBC underwent RC with ONB or IC urinary diversion. QoL was measured using the EORTC QLQ C30 and the Short-Form SF-36 questionnaires before surgery and at 12 months postoperatively. Baseline characteristics, including demographic profile, BMI, Charlson Comorbidity Index (CCI), modified Frailty Index (m-FI), pathological tumor stage, Clavien-Dindo grade, and neo-adjuvant chemotherapy were recorded and compared.

Results: The uni-variate and multivariate analysis (OR) were performed for constipation, diarrhea and m-FI of patients underwent RC for localized MIBC according to global health status score (poor/good vs. very good). Multivariate analysis showed that constipation medium/high was significant associated with global health status poor/good (OR=2.39; 95% CI: 1.22-4.71; P=0.01); Diarrhea medium/high was associated with global health status poor/good (OR=2.85; 95% CI:1.18-6.92; P=0.02), and m-FI ≥2 score (OR=2.13; 95% CI: 0.99-4.57; P=0.05).

Conclusions: Diarrhea and constipation are associated with a lower QoL in cystectomized patients, both with ONB or IC urinary diversion; such association is especially significant in more fragile patients (Frailty Index ≥2).

MeSH terms

  • Aged
  • Constipation / epidemiology
  • Constipation / etiology
  • Cystectomy* / adverse effects
  • Diarrhea / epidemiology
  • Diarrhea / etiology
  • Female
  • Global Health
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life* / psychology
  • Surveys and Questionnaires
  • Time Factors
  • Urinary Bladder Neoplasms* / psychology
  • Urinary Bladder Neoplasms* / surgery
  • Urinary Diversion / adverse effects