Noritoshi Sekido1,2, Ei-Ichiro Takaoka3, Hiroyuki Nishiyama4, Hiroyuki Ochi5, Toyomi Satoh5. 1. Department of Urology, Tsukuba University Hospital, Ibaraki, Japan. 2. Department of Urology, School of Medicine, Faculty of Medicine, Toho University Ohashi Medical Center, Tokyo, Japan. 3. Department of Renal and Urological Surgery, School of Medicine, Faculty of Medicine, International University of Health and Welfare, Chiba, Japan. 4. Department of Urology and Andrology, Majors of Medical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan. 5. Departments of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Abstract
AIMS: We investigated the quality of life (QOL) of a homogenous group of ambulant patients with neurogenic lower urinary tract dysfunction without significant comorbidities to elucidate the impact of clean intermittent catheterization (CIC) on QOL. METHODS: The subjects were 71 female patients who underwent radical hysterectomy (RH) without recurrent disease. QOL was cross-sectionally measured with the Short-Form 36-Item Health Survey (SF-36) and King's Health Questionnaire (KHQ). We divided urinary management into spontaneous voiding (SV) and CIC as well as postoperative elapsed time into the entire period, less than 24 months (<24 months) and 24 months or more (≥24 months). RESULTS: Patients with CIC showed significantly poorer QOL than patients with SV in some subscale/domain scores on SF-36 and KHQ for the entire period as well as <24 months after RH. In contrast, significant differences were not revealed between scores on both measures of patients with CIC and SV ≥24 months after RH. Moreover, in patients with CIC ≥24 months, some subscale/domain scores on both measures were significantly better than in those with <24 months. Norm-based scoring of SF-36 revealed that all subscales of patients with CIC <24 months were below the average score of healthy Japanese people, while only four subscales of those ≥24 months remained below the average. CONCLUSIONS: QOL in patients with CIC was worse than in patients with SV in the short term, but similar in the long term, which suggests that QOL probably might improve with time in patients with CIC.
AIMS: We investigated the quality of life (QOL) of a homogenous group of ambulant patients with neurogenic lower urinary tract dysfunction without significant comorbidities to elucidate the impact of clean intermittent catheterization (CIC) on QOL. METHODS: The subjects were 71 female patients who underwent radical hysterectomy (RH) without recurrent disease. QOL was cross-sectionally measured with the Short-Form 36-Item Health Survey (SF-36) and King's Health Questionnaire (KHQ). We divided urinary management into spontaneous voiding (SV) and CIC as well as postoperative elapsed time into the entire period, less than 24 months (<24 months) and 24 months or more (≥24 months). RESULTS:Patients with CIC showed significantly poorer QOL than patients with SV in some subscale/domain scores on SF-36 and KHQ for the entire period as well as <24 months after RH. In contrast, significant differences were not revealed between scores on both measures of patients with CIC and SV ≥24 months after RH. Moreover, in patients with CIC ≥24 months, some subscale/domain scores on both measures were significantly better than in those with <24 months. Norm-based scoring of SF-36 revealed that all subscales of patients with CIC <24 months were below the average score of healthy Japanese people, while only four subscales of those ≥24 months remained below the average. CONCLUSIONS: QOL in patients with CIC was worse than in patients with SV in the short term, but similar in the long term, which suggests that QOL probably might improve with time in patients with CIC.