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.
Keywords: Pelvic exenteration; Quality of life; Urinary diversion.
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