[The W-shaped ileal neobladder: Long term functional outcomes and health-related quality of life]. / La néovessie iléale en W : résultats fonctionnels et qualité de vie à long terme.

ABSTRACT

PURPOSE: To evaluate functional outcomes and patients' health-related quality of life over ten years after a W-shaped ileal neobladder urinary diversion. PATIENTS AND METHODS: From 1994 to 2004, 87 patients with bladder cancer underwent a cystoprostatectomy with a W-shaped ileal neobladder. Among them, 31 patients (35.6%) were evaluated. The average follow-up was 158months, average age was 72years. We assessed functional outcomes (use of protections, USP score, uroflowmetry, postvoid residual volume), overall health-related quality of life (SF-36 score), and specific urinary-related quality of life (Ditrovie scale). RESULTS: Daytime continence was satisfactory in 29 patients (96.8%). Night-time continence was satisfactory in 27 patients (87.1%). Mean daytime continence, hyperactivity and dysuria scores of the USP were respectively 1.5/9, 3.2/21 and 2/9. Mean value of the maximum flow rate was 18mL/s for an average voiding volume of 324mL and an average postvoid residual volume of 70mL. The 8 dimensions of the SF-36 were all comparable with the French population's values. According to the Ditrovie scale whose average value was 1.83, the health-related quality of life was unchanged or little changed by urinary disorders in 28 patients (90.3%). CONCLUSIONS: Our results suggest that voiding status and health-related quality of life remain satisfactory over ten years after an orthotopic ileal neobladder derivation. LEVEL OF EVIDENCE 5.