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International Journal of Urology (2014)
Editorial Comment Editorial Comment to Health-related quality of life after radical cystectomy and neobladder reconstruction in women: Impact of voiding and continence status The quality of life after treatment of malignant diseases has gained greater concern in the contemporary medical practice. In this interesting trial, the authors investigated the healthrelated quality of life (HRQOL) in a large series of women with orthotopic neobladder after radical cystectomy.1 The authors used the Arabic translation of two reliable questionnaires (EORTC-QLQ-C30 and FACT-Bl) to address this issue. Nevertheless, I am not completely satisfied by the translation of some items of the FACT-Bl questionnaire, such as “ostomy appliance” and “I have control of my bowels”. Therefore, the Arabic versions of these important questionnaires are needed to be revised and validated to improve the methodology of future researches. On the other hand, there are other methodological issues to consider. In the first part of this project, the authors compared the study group to a normal control group. However, at the end of their results, it was evident that the study cohort was not a homogenous sample, as it included three subgroups (spontaneous voiding, chronic urinary retention and night-time incontinence), and there were significant differences between these subgroups. Therefore, the authors should have compared each of these subgroups separately to the control group to obtain a sound and more meaningful comparison. The other point in this regard is that the marital status of the control group was significantly different from that of the study group (Table 1), and this might make the two groups non-comparable. This should not be underestimated, because there are many items in the
© 2014 The Japanese Urological Association
two studied questionnaires that explore sexual and social functions. When the authors studied the impact of the associated diseases on HRQOL, they put all “other comorbidities” in one package as a single entity (Table 4). This should be interpreted cautiously, because according to the available results, the reader will get the impression that any associated comorbidities regardless of its type or its severity have no impact on HRQOL. Finally, more studies are warranted to compare the HRQOL of each of the three demonstrated voiding types with that achieved after other types of diversion, such as ileal conduit, in a comparable group of women, to help the surgeon in counseling of such cases. Osama Mostafa El-Gamal F.R.C.S., M.D. Urology Department, Tanta University, Tanta, Egypt [email protected] DOI: 10.1111/iju.12503
Conflict of interest None declared.
Reference 1 Zahran MH, El-Hefnawy AS, Zidan EM, El-Bilsha MA, Taha DE, Ali-El-Dein B. Health-related quality of life after radical cystectomy and neobladder reconstruction in women: impact of voiding and continence status. Int. J. Urol. 2014; doi: 10.1111/iju.12452.
1
International Journal of Urology (2014)
Editorial Comment Editorial Comment to Health-related quality of life after radical cystectomy and neobladder reconstruction in women: Impact of voiding and continence status The quality of life after treatment of malignant diseases has gained greater concern in the contemporary medical practice. In this interesting trial, the authors investigated the healthrelated quality of life (HRQOL) in a large series of women with orthotopic neobladder after radical cystectomy.1 The authors used the Arabic translation of two reliable questionnaires (EORTC-QLQ-C30 and FACT-Bl) to address this issue. Nevertheless, I am not completely satisfied by the translation of some items of the FACT-Bl questionnaire, such as “ostomy appliance” and “I have control of my bowels”. Therefore, the Arabic versions of these important questionnaires are needed to be revised and validated to improve the methodology of future researches. On the other hand, there are other methodological issues to consider. In the first part of this project, the authors compared the study group to a normal control group. However, at the end of their results, it was evident that the study cohort was not a homogenous sample, as it included three subgroups (spontaneous voiding, chronic urinary retention and night-time incontinence), and there were significant differences between these subgroups. Therefore, the authors should have compared each of these subgroups separately to the control group to obtain a sound and more meaningful comparison. The other point in this regard is that the marital status of the control group was significantly different from that of the study group (Table 1), and this might make the two groups non-comparable. This should not be underestimated, because there are many items in the
© 2014 The Japanese Urological Association
two studied questionnaires that explore sexual and social functions. When the authors studied the impact of the associated diseases on HRQOL, they put all “other comorbidities” in one package as a single entity (Table 4). This should be interpreted cautiously, because according to the available results, the reader will get the impression that any associated comorbidities regardless of its type or its severity have no impact on HRQOL. Finally, more studies are warranted to compare the HRQOL of each of the three demonstrated voiding types with that achieved after other types of diversion, such as ileal conduit, in a comparable group of women, to help the surgeon in counseling of such cases. Osama Mostafa El-Gamal F.R.C.S., M.D. Urology Department, Tanta University, Tanta, Egypt [email protected] DOI: 10.1111/iju.12503
Conflict of interest None declared.
Reference 1 Zahran MH, El-Hefnawy AS, Zidan EM, El-Bilsha MA, Taha DE, Ali-El-Dein B. Health-related quality of life after radical cystectomy and neobladder reconstruction in women: impact of voiding and continence status. Int. J. Urol. 2014; doi: 10.1111/iju.12452.
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