Comparison of the quality of life between ileal conduit and orthotopic neobladder in post radical cystectomy bladder cancer male patients using the FACT-BL questionnaire

Abstract

Objective: Radical cystectomy (RC) is standard treatment for bladder cancer. Removal of the bladder requires reconstruction of the lower urinary tract, a procedure that also has impact on the patient’s quality of life (QoL). In Thailand, information pertinent to the level of the quality of life between ileal conduit and orthotopic neobladder is still limited. The objectives of this study are to evaluate the quality of life (primary outcome) and oncologic outcome (secondary outcome) of patients who underwent an Ileal Conduit (IC) or Orthotopic Neobladder (NB) using FACT-BL, a bladder-cancer-specific questionnaire. Materials and Methods: One hundred and forty six patients underwent radical cystectomy and urinary diversion for bladder cancer from 2009 to 2019 at our institution. Out of these, 61 (42%) patients were asked to participate in this study. All 61, who were divided into two groups, 34 IC and 27 NB, completed the ques- tionnaire, a survey response rate of 100%. Mean follow-up was 7 years 3 months. Results: There were no statistically significant differences in ll FACT-G categories (PWB, SWB, EWB and FWB) between the two groups. Patients with neobladder had reported that they urinated more frequently than usual. Mean interest in sex was 49% in all patients and capability of maintaining an erection was 23%. The mean total values of FACT-BL in IC and NB patients were 128.51 ± 15.51 and 126.70 ± 17.35, showing no significant difference. Conclusion: Prinary diversion type does not appear to be associated with differential post-operative QoL and sexual satisfaction. There is a possibility that patients with neobladder urinate more frequently than before surgery but this did not reach statistical significance.