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Étude prospective de l’impact sur la qualité de vie de la réalisation d’une dérivation urinaire cutanée transiléale non continente pour troubles vésicosphinctériens d’origine neurologique

Prospective study assessing the impact on the quality of life of ileal conduit for neurological bladder dysfunction

  • Article Original / Original Article
  • Published:
Pelvi-périnéologie

Résumé

Objectifs

Le but de cette étude était d’évaluer l’impact de la réalisation d’une dérivation urinaire non continente transiléale de type Bricker sur la qualité de vie (QdV) des patients ayant des troubles vésicosphinctériens (TVS) d’origine neurologique.

Matériel et méthodes

De mars 2004 à octobre 2009, 50 patients, 32 femmes et 18 hommes, âgés en moyenne de 55,5 ± 11,8 ans, ayant eu une cystectomie avec dérivation urinaire non continente transiléale de type Bricker pour des TVS d’origine neurologique, ont rempli de manière prospective un autoquestionnaire avant et un an après la chirurgie. Les pathologies neurologiques étaient une sclérose en plaques (SEP) dans 34 cas, une lésion médullaire dans neuf cas, un spina-bifida avec myéloméningocèle dans deux cas et d’autres pathologies neurologiques dans cinq cas. La QdV était mesurée à l’aide de deux autoquestionnaires, un spécifique des troubles urinaires validé chez les patients neurologiques, Qualiveen®, et un généraliste SF36-v2®.

Résultats

Concernant le questionnaire Qualiveen®, après chirurgie, les patients avaient une diminution significative du score de gêne (0,56 ± 0,62 versus 1,55 ± 1,35, p < 0,001), de craintes (1,15 ± 0,74 versus 1,56 ± 1,03, p < 0,05), de contraintes (2,04 ± 0,88 versus 2,55 ± 1,18, p < 0,05) ainsi que de l’indice ISPU (impact spécifique des problèmes urinaires) [1,21 ± 0,65 versus 1,83 ± 1,04, p < 0,01]. Aucune modification significative des scores du SF36-v2® n’a été notée en postopératoire.

Conclusion

La dérivation urinaire non continente transiléale de type Bricker améliore la QdV urinaire des patients présentant des TVS d’origine neurologique, en diminuant la gêne, les craintes et la contrainte engendrées par les troubles urinaires.

Abstract

Objectives

The aim of this study was to assess the impact on the quality of life after carrying out an ileal conduit for neurogenic bladder dysfunction.

Material and methods

Between March 2004 and December 2009, 50 patients, 32 women and 18 men, mean age 55.5 ± 11.8 years, were enrolled in a prospective survey, using two validated self-administrated questionnaires: Qualiveen® and SF36.v2, which were filled by the patients the day before and one year after the surgery. Neurological conditions were multiple sclerosis in 34 cases, spinal cord injury in 9, spina-bifida and myelomeningocele in 2 and miscellaneous in 5.

Results

The Qualiveen® questionnaire scores after the surgery showed a significant decrease in limitations (0.56 ± 0.62 versus 1.55 ± 1.35, P < 0.001), fears (1.15 ± 0.74 versus 1.56 ± 1.03, P < 0.05), constraints (2.04 ± 0.88 versus 2.55 ± 1.18, P < 0.05) and ISPU index (1.21 ± 0.65 versus 1.83 ± 1.04, P < 0.01). No significant difference was noticed in SF36.v2 scores before and after the surgery.

Conclusion

Ileal conduit, decreasing limitations, fears and constraints, improves urinary-related quality of life of patients with neurogenic bladder dysfunction.

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Authors and Affiliations

  1. Service d’urologie, de transplantation rénale et d’andrologie, CHU de Rangueil, TSA 50032, F-31059, Toulouse cedex 09, France

    J. Guillotreau, M. Roumiguié, B. Malavaud, P. Rischmann & X. Gamé

  2. Service de médecine physique et de réadaptation, CHU de Rangueil, TSA 50032, F-31059, Toulouse cedex 09, France

    E. Castel-Lacanal, X. De Boissezon & P. Marque

Authors
  1. J. Guillotreau
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  2. E. Castel-Lacanal
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  3. M. Roumiguié
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  4. X. De Boissezon
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  5. B. Malavaud
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  7. P. Rischmann
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  8. X. Gamé
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Correspondence to X. Gamé.

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Guillotreau, J., Castel-Lacanal, E., Roumiguié, M. et al. Étude prospective de l’impact sur la qualité de vie de la réalisation d’une dérivation urinaire cutanée transiléale non continente pour troubles vésicosphinctériens d’origine neurologique. Pelv Perineol 5, 144–149 (2010). https://doi.org/10.1007/s11608-010-0334-x

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  • DOI: https://doi.org/10.1007/s11608-010-0334-x

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