AUA 2017: Cross-sectional Study Evaluating Long-term Bowel Issues in Bladder Cancer Patients: Diarrhea as a Limiting Factor of Quality of Life After Radical Cystectomy

Boston, MA ( A significant number of patients after radical cystectomy (RC) suffer from changes in bowel habits and defecation. Dr. Hupe presented a cross sectional study evaluating long-term bowel issues in a large cohort with the help of a tailored questionnaire.

A questionnaire assessing changes in bowel function and its impact on daily life was developed and distributed in collaboration with the German bladder cancer support group. A total of 431 patients after RC were evaluated. Symptoms such as diarrhea, constipation, urge to defecate, sensation of incomplete defecation, flatulence, and impact on quality of life (QoL) were evaluated.

A total of 324 patients were finally analyzed and followed ≥1 year. 43% of the patients reported current bowel disorders, 40% life restriction and 60% dissatisfaction. Most frequent bowel symptoms were flatulence (49%), followed by diarrhea (30%) and the sensation of incomplete defecation (23%). The highest prevalence rate of diarrhea was reported in year 3 after surgery. Flatulence is also a long-term bowel symptom with a prevalence of 50% ≥1 year vs 37% <1 year after surgery (p=0.0334). The prevalence of the remaining bowel symptoms did not change over time. After 12 months, diarrhea significantly correlated with flatulence, uncontrolled stool loss, urge to defecate, younger age at time of surgery, and the size of bowel segment used for urinary diversion (all p<0.01). Patients suffering from diarrhea reported a higher defecation frequency, a lower QoL, a higher dissatisfaction level, a lower energy level (all p<0.01), and a lower health state (p=0.0488).

Dr. Hupe concluded that diarrhea is a prominent long-term bowel symptom after RC with a large impact on daily life. A better understanding of long-term bowel symptoms can help daily clinical management, and optimize surgical procedures, post-operative medication/nutrition and patient education.

Presented By: Marie Hupe, Luebeck, Germany

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA