Assessment of long-term quality of life in patients with orthotopic neobladder followed for more than 5 years.

INTRODUCTION: We analyzed the general health QOL (GH-GOL), urinary QOL, and sexual QOL in patients with orthotopic neobladder who were followed for more than 5 years.
MATERIALS AND METHODS: Eighty-six (male 78, female 8) patients who underwent orthotopic neobladder and followed for more than 5 years were enrolled in this study. QOL regarding general health and urinary function were surveyed by SF-36 and ICSmaleSF, respectively. Sexual function was assessed by International Index of Erectile Function (IIEF-5). Satisfaction with urinary and sexual function was evaluated by visual analogue scale (VAS).
RESULTS: On overall analysis by SF-36, 2 categories (role-physical functioning and role-emotional functioning) showed significantly lower scores, although bodily pain showed a better than average score for Japanese people of the same age. While patients who required clean intermittent catheterizaion (CIC) or had daytime incontinence presented worse scores in several categories on SF-36, the presence of enuresis did not affect SF-36 score. ICSmaleSF survey showed that voiding symptoms significantly impaired QOL in patients who required CIC and incontinence symptoms significantly impaired QOL in patients who had daytime incontinence and enuresis. With regard to sexual function, most patients (88%) had lost sexual function. On VAS, satisfaction with urinary function was 5.63, and sexual function was only 0.98.
CONCLUSIONS: Although GH-QOL was generally well maintained, the presence of CIC or daytime incontinence impaired GH-QOL. Most were not satisfied with their level of sexual function 5 years after orthotopic neobladder construction.