QUALITY OF LIFE IN WOMEN AFTER ANTERIOR PELVIC EXENTERATION

60 women, who underwent anterior pelvic exenteration with different types of urine derivation since 2004 till 2014 years in urology department, RMAPO, S.P. Botkin city hospital, were included in retrospective investigation. Middle age of patients was 53,2±3 (32-68). 38 women with bladder cancer and 22 women with urinary injuries after radiation therapy underwent anterior pelvic exenteration. Aim of this work is to perform quality of life comparison of patients after anterior pelvic exenteration with different types of urine derivation. Patients were divided in 3 groups: 1-st group 39 (65%) women, who underwent Bricker’s operation, 2-nd group 19 (31,66% ) women, who had Studer’s operation and 3-rd group - 2 (3,34%), patients who underwent continent urine derivation with formation of catheterizing urinary reservoir. Questionnaire (SF-36) was used to evaluate quality of life. Observation period was from 2 to 10 years. Postsurgical lethality was 3%, 5-years survival rate was 60,9±15,8% and 5-years recurrence-free survival rate was 55,4±12,6%. We established that quality of life in women who underwent orthotopic urine derivation was higher than in patients who underwent incontinent ileoconduit formation. Better quality oflife was demonstrated by women, who had catheterizing urinary reservoir, but it is difficult to compare this group with the others, because of small number of patients with heterotopic catheterizing reservoir. Regarding the results of our investigation we made next conclusions: • In spite of difficult technique, high risk of postoperative complications and lethality, anterior pelvic exenteration provide 5-years survival rate for 70% of patients • In locally advanced tumors of pelvic organs anterior pelvic exenteration is salvational operation and keep satisfactory quality of life • Orthotopic intestinal urine derivation is better to provide satisfactory quality of life for patients with invasive bladder cancer. • For women with urinary injuries after radiation therapy Briker’s operation is better type of urine derivation, in special cases heterotopic catheterizing reservoirs can be made.

pelvic exenteration, pelvic tumors, intestinal urine derivation, quality of life after intestinal urine derivation, quality of life questionnaire after intestinal urine derivation