LAUSR

OBJECTIVE To characterize the health related quality of life reported by patients who received an ileal conduit, Indiana pouch, or neobladder urinary diversion after radical cystectomy. MATERIALS AND METHODS The FACT-VCI survey was administered to patients with bladder cancer undergoing radical cystectomy and urinary diversion from 2015-2018. Surveys were completed prior to radical cystectomy and then longitudinally throughout the post-operative course. RESULTS 146 patients completed questionnaires over a median of 12.3 months, 83 (56.8%) received an ileal conduit, 31 (21.2%) an Indiana pouch, and 32 (21.9%) an orthotopic neobladder. There were no significant differences in HRQOL among urinary diversion groups considering the Trial Outcome Index scores, general overall FACT-G assessment, or total FACT-VCI instruments. Patients who received ileal conduits were older and had higher Charlson Comorbidity Index scores (p<0.005) yet still experienced similar improvements in HRQOL commensurate with the other diversion cohorts. There was a significant difference in physical well-being favoring neobladder over ileal conduit or Indiana Pouch urinary diversions (p<0.05). CONCLUSIONS To our knowledge this is the first and largest quality of life analysis comparing all three methods of urinary diversion in a longitudinal fashion utilizing a standardized, validated, treatment-specific health survey. Proper preoperative counseling is critical to ensure understanding of the benefits of available urinary diversion.