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Gynecologic Oncology Jun 2013To compare outcomes of patients undergoing continent or incontinent urinary diversion after pelvic exenteration for gynecologic malignancies. (Comparative Study)
Comparative Study
OBJECTIVE
To compare outcomes of patients undergoing continent or incontinent urinary diversion after pelvic exenteration for gynecologic malignancies.
METHODS
Data on patients who underwent pelvic exenteration for gynecologic malignancies at The University of Texas MD Anderson Cancer Center between January 1993 and December 2010 were collected. A multivariate logistic regression model was used and statistical significance was P<0.05.
RESULTS
A total of 133 patients were included in this study. The mean age at exenteration was 47.6 (range, 30-73) years in the continent urinary diversion group and 57.2 (range, 27-86) years in the incontinent urinary diversion group (P<0.0001). Forty-six patients (34.6%) had continent urinary diversion, and 87 patients (65.4%) had incontinent urinary diversion. The rates of postoperative complications in patients with continent and incontinent urinary diversion, respectively, were as follows: pyelonephritis, 32.6% versus 37.9% (P=0.58); urinary stone formation, 34.8% versus 2.3% (P<0.001); renal insufficiency, 4.4% versus 14.9% (P=0.09); urostomy stricture, 13.0% versus 1.2% (P=0.007); ureteral (anastomotic) leak, 4.4% versus 6.9% (P=0.71); ureteral (anastomotic) stricture, 13.0% versus 23% (P=0.25); fistula formation, 21.7% versus 19.5% (P=0.82); and reoperation because of complications of urinary diversion, 6.5% versus 2.3% (P=0.34). Among patients with continent urinary diversion, the incidence of incontinence was 28.3%, and 15.2% had difficulty with self-catheterization.
CONCLUSION
There were no differences in postoperative complications between patients with continent and incontinent conduits except that stone formation was more common in patients with continent conduits.
Topics: Adult; Aged; Aged, 80 and over; Female; Genital Neoplasms, Female; Humans; Middle Aged; Pelvic Exenteration; Treatment Outcome; Urinary Diversion; Urinary Incontinence; Urinary Reservoirs, Continent; Young Adult
PubMed: 23480870
DOI: 10.1016/j.ygyno.2013.02.024 -
Health Expectations : An International... Dec 2017There is a recognized need to include patients in setting research priorities. Research priorities identified by people with a stoma are rarely elicited.
BACKGROUND
There is a recognized need to include patients in setting research priorities. Research priorities identified by people with a stoma are rarely elicited.
OBJECTIVES
To improve the quality of life of people with a stoma through use of evidence-based practice based on research priorities set by patients.
DESIGN AND METHODS
Online pilot survey publicized in 2016 via United Kingdom stoma charities. People ranked nine stoma-related quality of life topics in order of research priority.
PARTICIPANTS
People 16 years of age and over who currently have or have had a stoma for treatment for any medical condition.
ANALYSIS
Distributions of the priority scores for each of the nine research topics were examined. Group differences were explored using either the Mann-Whitney U-test or the Kruskal-Wallis test depending on the number of groups.
RESULTS
In total, 225 people completed the survey. The most important research priority was pouch leak problems and stoma bag/appliance problems followed by hernia risk. There were statistically significant differences in ranking research priorities between males and females, age, underlying disease that led to a stoma, stoma type and length of time with a stoma.
CONCLUSION
People with a stoma are willing to engage in and set research priorities. The results should contribute towards future research about setting the research agenda for the study of stoma-related concerns that impact quality of life.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Evidence-Based Practice; Female; Humans; Male; Middle Aged; Pilot Projects; Quality of Life; Research; Sex Factors; Surgical Stomas; Surveys and Questionnaires; Time Factors; United Kingdom
PubMed: 28675608
DOI: 10.1111/hex.12585