Five-year quality-of-life assessment by urinary diversion type after pelvic Exenterations

Objective

To determine whether urinary diversion procedures performed at time of pelvic exenteration affect quality of life in patients with recurrent gynecologic malignancies.

Methods

We performed a retrospective secondary longitudinal analysis of quality of life according to type of urinary diversion patients received. Participants completed a series of validated questionnaires at various time points. We allocated patients based on urinary diversion type to either the continent group (CD; 29 [55 %]) or noncontinent group (NCD; 24 [45 %]).

Results

We noted a significant improvement in global health scores from baseline over time (time p = 0.027). Physical functioning scores showed a statistically significant difference over time (at 24 months: NCD, −4.3 [95 % CI, −14.1 to 5.4]; CD, 0.4 [95 % CI, −7.1 to 7.9]. p < 0.001). Social functioning scores were persistently higher for the CD vs NCD group at all time points but did not differ significantly between the groups at baseline (p = 0.75) or over time within the same group (time p = 0.122). Body image scores significantly decreased (reduced burden) over time for both groups (p = 0.044) and were consistently higher in the NCD vs CD group.

Conclusions

Patients experienced a return to their baseline quality of life within a year of surgery. Clinicians should prioritize and improve identifying and discussing postoperative challenges such as changes in physical and social functioning and body image.