Assessment of long-term quality of life in patients with orthotopic neobladder followed for more than 5 years
Assessment of long-term quality of life in patients with orthotopic neobladder followed for more than 5 years
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DOI：
10.1007/s11255-010-9851-3
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发表时间：
2011-09-01
影响因子：
2
通讯作者：
Fujisawa, Masato
中科院分区：
文献类型：
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作者：
Takenaka, Atsushi;Hara, Isao;Fujisawa, Masato
对86例（男78例，女8例）行原位新膀胱术并随访5年以上的患者进行一般健康生活质量（GH-GOL）、泌尿生活质量和性生活质量的分析。分别采用SF-36和ICSmaleSF调查患者的一般健康和泌尿功能的QOL。采用国际勃起功能指数（IIEF-5）评估性功能。通过视觉模拟量表（VAS）评估泌尿和性功能的满意度。在SF-36的总体分析中，2个类别（角色-身体功能和角色-情绪功能）的评分显著较低，尽管身体疼痛的评分优于同龄日本人的平均评分。虽然需要清洁间歇性导尿（CIC）或白天尿失禁的患者在SF-36的几个类别中表现出更差的评分，但遗尿症的存在并不影响SF-36评分。ICSmaleSF调查显示，需要CIC的患者的排尿症状显著损害QOL，而日间失禁和遗尿患者的失禁症状显著损害QOL。在性功能方面，大多数患者（88%）丧失了性功能。VAS评分中，对排尿功能的满意度为5.63，对性功能的满意度仅为0.98。虽然GH-QOL总体维持良好，但CIC或日间失禁的存在损害了GH-QOL。大多数人对原位新膀胱术后5年的性功能水平不满意。
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.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).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.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.