HETEROTOPIC CONTINENT OR INCONTINENT URINARY DIVERSION:MAKING THE OPTIMAL CHOICE

Introduction. Quality of life and survival rate of post-cystectomy patients depend on the urinary diversion methods [1,2].Purpose of the study. A comparison of morbidity, survival rate, and quality of life in patients after heterotopic continent or incontinent urinary diversions.Materials and method...

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Main Authors: V A Perepechay, I M Spitsyn, O N Vasilyev, M I Kogan
Format: Article
Language:English
Published: Eco-vector 2017-03-01
Series:Клиническая практика
Subjects:
Online Access:https://journals.eco-vector.com/clinpractice/article/viewFile/8063/6485
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author V A Perepechay
I M Spitsyn
O N Vasilyev
M I Kogan
author_facet V A Perepechay
I M Spitsyn
O N Vasilyev
M I Kogan
author_sort V A Perepechay
collection DOAJ
description Introduction. Quality of life and survival rate of post-cystectomy patients depend on the urinary diversion methods [1,2].Purpose of the study. A comparison of morbidity, survival rate, and quality of life in patients after heterotopic continent or incontinent urinary diversions.Materials and methods. During the period from 1998 to 2016, 36 heterotopic intestinal diversions were performed using urine containment method according to the Kock pouch scheme in our modification, and 61 incontinent heterotopic intestinal Bricker diversions. We evaluated the comorbid conditions (Charlson comorbidity index), postoperative complications (acc. to Clavien-Dindo), survival rate (acc. to E.L. Kaplan, P. Meier), and the quality of life of patients (SF-36) using complex statistical analysis.Results. Early and late complications not related and related to urinary diversion prevailed in the group of patients after Bricker surgery without statistical significance. With longer postoperative monitoring periods the share of complications related to urinary diversion increases, while the frequency of delayed complications and survival rate show no statistical difference in both groups. No reliable differences were revealed in the quality of life in all cases of cutaneous urinary diversion.Discussion. 80% of patients after the Kock pouch surgery (mod.) throughout the medium follow-up period of over 5 years remain continent and enjoy high quality of life. It is necessary to develop and implement in clinical practice new and more advanced statistical tools for evaluation of the patients’ quality of life depending upon the type of urinary diversion after cystectomy.Conclusion. Heterotopic continent diversion (Kock pouch (mod.)) in comparison with the incontinent method (Bricker) does not increase morbidity or decrease the survival rate, and provides for higher quality of life.
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spelling doaj.art-dd5d8cca07584ae2a9b1ab8128eb41862023-09-03T10:06:03ZengEco-vectorКлиническая практика2220-30952618-86272017-03-0181505710.17816/clinpract8150-577509HETEROTOPIC CONTINENT OR INCONTINENT URINARY DIVERSION:MAKING THE OPTIMAL CHOICEV A PerepechayI M SpitsynO N VasilyevM I KoganIntroduction. Quality of life and survival rate of post-cystectomy patients depend on the urinary diversion methods [1,2].Purpose of the study. A comparison of morbidity, survival rate, and quality of life in patients after heterotopic continent or incontinent urinary diversions.Materials and methods. During the period from 1998 to 2016, 36 heterotopic intestinal diversions were performed using urine containment method according to the Kock pouch scheme in our modification, and 61 incontinent heterotopic intestinal Bricker diversions. We evaluated the comorbid conditions (Charlson comorbidity index), postoperative complications (acc. to Clavien-Dindo), survival rate (acc. to E.L. Kaplan, P. Meier), and the quality of life of patients (SF-36) using complex statistical analysis.Results. Early and late complications not related and related to urinary diversion prevailed in the group of patients after Bricker surgery without statistical significance. With longer postoperative monitoring periods the share of complications related to urinary diversion increases, while the frequency of delayed complications and survival rate show no statistical difference in both groups. No reliable differences were revealed in the quality of life in all cases of cutaneous urinary diversion.Discussion. 80% of patients after the Kock pouch surgery (mod.) throughout the medium follow-up period of over 5 years remain continent and enjoy high quality of life. It is necessary to develop and implement in clinical practice new and more advanced statistical tools for evaluation of the patients’ quality of life depending upon the type of urinary diversion after cystectomy.Conclusion. Heterotopic continent diversion (Kock pouch (mod.)) in comparison with the incontinent method (Bricker) does not increase morbidity or decrease the survival rate, and provides for higher quality of life.https://journals.eco-vector.com/clinpractice/article/viewFile/8063/6485cystectomyurinary diversionheterotopiccontinentquality of life
spellingShingle V A Perepechay
I M Spitsyn
O N Vasilyev
M I Kogan
HETEROTOPIC CONTINENT OR INCONTINENT URINARY DIVERSION:MAKING THE OPTIMAL CHOICE
Клиническая практика
cystectomy
urinary diversion
heterotopic
continent
quality of life
title HETEROTOPIC CONTINENT OR INCONTINENT URINARY DIVERSION:MAKING THE OPTIMAL CHOICE
title_full HETEROTOPIC CONTINENT OR INCONTINENT URINARY DIVERSION:MAKING THE OPTIMAL CHOICE
title_fullStr HETEROTOPIC CONTINENT OR INCONTINENT URINARY DIVERSION:MAKING THE OPTIMAL CHOICE
title_full_unstemmed HETEROTOPIC CONTINENT OR INCONTINENT URINARY DIVERSION:MAKING THE OPTIMAL CHOICE
title_short HETEROTOPIC CONTINENT OR INCONTINENT URINARY DIVERSION:MAKING THE OPTIMAL CHOICE
title_sort heterotopic continent or incontinent urinary diversion making the optimal choice
topic cystectomy
urinary diversion
heterotopic
continent
quality of life
url https://journals.eco-vector.com/clinpractice/article/viewFile/8063/6485
work_keys_str_mv AT vaperepechay heterotopiccontinentorincontinenturinarydiversionmakingtheoptimalchoice
AT imspitsyn heterotopiccontinentorincontinenturinarydiversionmakingtheoptimalchoice
AT onvasilyev heterotopiccontinentorincontinenturinarydiversionmakingtheoptimalchoice
AT mikogan heterotopiccontinentorincontinenturinarydiversionmakingtheoptimalchoice