Quality of Life Analysis in Patients with Simple Cutaneous Ureterostomy versus Ileal Conduit Bricker Following Radical Cystectomy
Cosmin-George Radu, George Daniel Rădăvoi, Justin Aurelian, Ion-Florin Achim, Iulia Andras, Maximilian Buzoianu, Elisabeta Ioana Hiriscau, Nicolae Crisan, Silviu Constantinoiu, Viorel JingaOriginal article, no. 2, 2025
Article DOI: 10.21614/chirurgia.3128
Introduction: Radical cystectomy (RC) with pelvic lymphadenectomy remains the standard therapeutic approach in the treatment of muscle-invasive bladder cancer (MIBC). The impact of urinary diversion type on postoperative health-related quality of life (HRQoL) remains a debated topic, especially in the context of Eastern European clinical practice.
Objective: This retrospective, observational, multicentric study aimed to compare the quality of life in patients undergoing RC followed by either simple cutaneous ureterostomy (SCU) or non-continent ileal conduit (Bricker), across two academic centers in Romania, utilizing different surgical approaches.
Material and Methods: A total of 46 patients diagnosed with non-metastatic MIBC were included and equally distributed into two groups. Quality of life was assessed at 3 months postoperatively using the EQ-5D-5L questionnaire and the EQ-VAS visual analogue scale. Indexed scores were calculated using a European value set. A multivariate linear regression was applied to identify independent predictors of quality of life scores.
Results: Patients in the Bricker group reported slightly higher EQ-VAS scores. Paradoxically, social support was associated with lower indexed scores (p 0.001), suggesting more severe functional impairment among patients requiring assistance. The type of surgical approach did not significantly impact quality of life. Male patients reported greater limitations in self-care and daily activities (p 0.05).
Conclusions: Both urinary diversion techniques yield comparable quality of life outcomes at 3 months postoperatively. Social support may serve as an indirect marker of functional vulnerability, emphasizing the need for an individualized and multidisciplinary approach.
Objective: This retrospective, observational, multicentric study aimed to compare the quality of life in patients undergoing RC followed by either simple cutaneous ureterostomy (SCU) or non-continent ileal conduit (Bricker), across two academic centers in Romania, utilizing different surgical approaches.
Material and Methods: A total of 46 patients diagnosed with non-metastatic MIBC were included and equally distributed into two groups. Quality of life was assessed at 3 months postoperatively using the EQ-5D-5L questionnaire and the EQ-VAS visual analogue scale. Indexed scores were calculated using a European value set. A multivariate linear regression was applied to identify independent predictors of quality of life scores.
Results: Patients in the Bricker group reported slightly higher EQ-VAS scores. Paradoxically, social support was associated with lower indexed scores (p 0.001), suggesting more severe functional impairment among patients requiring assistance. The type of surgical approach did not significantly impact quality of life. Male patients reported greater limitations in self-care and daily activities (p 0.05).
Conclusions: Both urinary diversion techniques yield comparable quality of life outcomes at 3 months postoperatively. Social support may serve as an indirect marker of functional vulnerability, emphasizing the need for an individualized and multidisciplinary approach.
Keywords: radical cystectomy, urinary diversion, simple cutaneous ureterostomy, ileal conduit (Bricker technique), quality of life, social support, EQ-5D-5L, EQ-VAS
