Background: The ileocecal rectal bladder (IRB) after cystectomy has been devised, in which continence is controlled by the anal sphincter. To assess how this procedure influences postoperative health-related quality of life (QOL), IRB patients were compared with ileal conduit (IC) patients using a questionnaire mail-out.
Methods: The questionnaire consisted of 35 questions. The questions were multiple choice and the answers were rated on a Linkert rank-type four-point scale. The IRB operation was performed on 29 patients between March 1990 and July 1998. The questionnaire was mailed to 21 of 29 IRB and 34 IRC patients, who underwent either operation during the same period abd had no persistent or recurrent tumor. Statistical analysis was performed by Mann-Whitney U-test.
Results: All 21 IRB patients (100%) and 24 IC patients (71%) responded to the questionnaire. The mean age and follow-up time of both groups were not significantly different. The IRB group had better scores in many items, especially, in those of self-care, turning over freely during sleep,and tension. However, 43% of IRB patients used pads for small amounts of incontinence (spotting) and worried about flatus.
Conclusion: These findings show that many functional and symptomatic health related QOL scores are better after IRB and support the use of this procedure of urinary diversion for selected patients.