Cross-sectional evaluation of long-term bowel issues after radical cystectomy.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 318-318
Author(s):  
Marie C Hupe ◽  
Winfried Vahlensieck ◽  
Martin Jp Hennig ◽  
Tomasz Ozimek ◽  
Julian Struck ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Bowel Function ◽  
Cross Sectional Study ◽  
Health State ◽  
Bowel Symptom ◽  
Cross Sectional ◽  
Bowel Symptoms ◽  
Number Of Patients ◽  
Bowel Disorders

318 Background: We had previously shown that a significant number of patients after radical cystectomy (RC) suffer from changes in bowel habits and defecation. Reports addressing long-term bowel disorders following RC are rare. This cross sectional study evaluates long-term bowel issues in a large cohort with the help of an issue-tailored questionnaire. Methods: For this purpose a questionnaire assessing changes in bowel function and its impact on daily life was developed and distributed among members of the German bladder cancer self-help 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 assessed. Results: A total of 324 patients were followed ≥1 year, 43% patients of those 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 is reported in year 3 after surgery: <3 months after surgery 14%, 3-11 months 21%, 12-23 months 18%, 24-35 months 44%, 36-59 months 36%, ≥60 months 27% (p<0.01). Also flatulence is a long-term bowel symptom with a prevalence of 50% ≥1 year vs 37% <1 year after surgery (p=0.0334), while the prevalence of other 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 for urinary diversion (all p<0.01). Patients suffering from diarrhea report 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). Conclusions: Diarrhea is a prominent long-term bowel symptom after RC. A better understanding of long-term bowel symptoms might lead to optimized surgical procedures, post-operative medication and patient education.

Assessment of bowel disorders following radial cystectomy and urinary diversion for muscle-invasive transitional cell carcinoma of the bladder.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 347-347
Author(s):  
Mario W. Kramer ◽  
Mohammad Kabbani ◽  
Abdul-Rahman Kabbani ◽  
Christoph A. J. von Klot ◽  
Hossein Tezval ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Medical Condition ◽  
Transitional Cell ◽  
Bowel Function ◽  
Pelvic Surgery ◽  
Current Status ◽  
Validated Questionnaire ◽  
Bowel Disorders

347 Background: Articles reporting and specifying bowel disorders after radical cystectomy as long-term complications are sparse. However, numerous patients report on bowel function alteration and/or defecation disorders or even stool incontinence. For better qualification and quantification we present our data of a large cohort of patients evaluated with a newly developed questionnaire. Methods: For this purpose a novel non validated questionnaire was developed. The questionnaire was sent to 253 patients who had been treated with radical cystectomy between 2006 and 2012 to assess possible changes in bowel function and its impact on health related quality of life. Of those, 89 patients reported on their current status. Questions were related to their overall satisfaction as well as to their quality and severity of bowel disorders following pelvic surgery for bladder cancer. Results: In total 40 (44.9%) patients reported of a persistent change in bowel function after surgery. Most frequent were constipation (28.9%), diarrhea (18.4%) or both (21.1%) followed by flatulence (31.6%). Patients who experienced bowel function alteration but who are still satisfied reported predominantly of constipation (35.3%) and flatulence (41.2%) but not diarrhea. Twenty-three (25.8%) patients are currently not satisfied with their bowel function. Of those, 82.6% complaint about frequent flatulence, 75% report on softer stools, 65.2% have irritable bowel symptoms, 26.1% experience faecal incontinence and 73.9% are affected by serious life restrictions due to bowel disorder. Defecation frequency increased significantly (p<0.001). There is a significant reduction in life quality (p=0.004), medical condition (p=0.008) and energy level (p=0.035). A significant correlation could be found for higher T-stage (p<0.05) and positive lymph nodes (p<0.03). No differences could be observed between patients who received ileal-conduit vs. orthotopic neobladder or MAINZ I pouch urinary diversion. Conclusions: Long-term bowel disorders after cystectomy are an underestimated issue. A better understanding might lead to modifications of surgical procedures.

Diarrhea and flatulence are major bowel disorders after radical cystectomy: Results from a cross-sectional study in bladder cancer patients

2018 ◽  
Vol 36 (5) ◽  
pp. 237.e1-237.e8 ◽  
Author(s):  
Marie C. Hupe ◽  
Winfried Vahlensieck ◽  
Tomasz Ozimek ◽  
Julian P. Struck ◽  
Martin J.P. Hennig ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Radical Cystectomy ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Bowel Disorders

scholarly journals Survey-Based Analysis of Current Trends for Prescribing Gastrointestinal Protectants among Small-Animal General Practitioners in Portugal

2021 ◽  
Vol 8 (5) ◽  
pp. 70
Author(s):  
Rita Baptista ◽  
Ryane Englar ◽  
Berta São Braz ◽  
Rodolfo Oliveira Leal
Keyword(s):  
General Practitioners ◽  
Healthcare Providers ◽  
Small Animal ◽  
Cross Sectional Study ◽  
Online Forums ◽  
Educational Strategies ◽  
Cross Sectional ◽  
Current Trends ◽  
Therapeutic Value

In both human and veterinary healthcare, gastrointestinal protectants (GIPs) are considered a staple of clinical practice in that they are prescribed by general practitioners (GPs) and specialists alike. Concerning GIP use, overprescription of proton pump inhibitors (PPIs) has become a growing concern among human healthcare providers. This trend has also been documented within veterinary practice, prompting the American College of Veterinary Internal Medicine (ACVIM) to publish a consensus statement in 2018 concerning evidence-based indications for GIP use. This observational cross-sectional study evaluated self-reported prescribing protocols among Portuguese GPs to determine whether there is adherence to the consensus guidelines. Respondents were Portuguese GPs recruited by social media posts in veterinarian online forums. Data were collected from 124 respondents concerning their GIPs of choice and their rationales for prescribing them. Data were mined for prescription patterns and protocols. Among GIPs, PPIs were prescribed more often. Rationales for use included gastrointestinal ulceration and erosion (GUE), prophylactic management of nonerosive gastritis, pancreatitis, reflux esophagitis, and steroid-induced ulceration. Once-daily administration of PPIs was the most frequent dosing regime among respondents. Ninety-six percent of PPI prescribers advocated that the drug be administered either shortly before or at mealtime. Forty-nine percent of respondents supported long-term use of PPIs. Fifty-nine percent of respondents acknowledged discontinuing PPIs abruptly. This study supports that Portuguese GPs commonly prescribe GIPs in accordance with ACVIM recommendations to medically manage GUE. However, misuse of GIPs does occur, and they have been prescribed where their therapeutic value is debatable. Educational strategies should target GPs in an effort to reduce GIP misuse.

scholarly journals A Cross-Sectional Study on the Impacts of Perceived Job Value, Job Maintenance, and Social Support on Burnout among Long-Term Care Staff in Hawaii

2021 ◽  
Vol 18 (2) ◽  
pp. 476
Author(s):  
Bum Jung Kim ◽  
Sun-young Lee
Keyword(s):  
Social Support ◽  
Long Term Care ◽  
Cross Sectional Study ◽  
Care Staff ◽  
Hierarchical Regression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Term Care ◽  
The Impact

Extensive research has demonstrated the factors that influence burnout among social service employees, yet few studies have explored burnout among long-term care staff in Hawaii. This study aimed to examine the impact of job value, job maintenance, and social support on burnout of staff in long-term care settings in Hawaii, USA. This cross-sectional study included 170 long-term care staff, aged 20 to 75 years, in Hawaii. Hierarchical regression was employed to explore the relationships between the key independent variables and burnout. The results indicate that staff with a higher level of perceived job value, those who expressed a willingness to continue working in the same job, and those with strong social support from supervisors or peers are less likely to experience burnout. Interventions aimed at decreasing the level of burnout among long-term care staff in Hawaii may be more effective through culturally tailored programs aimed to increase the levels of job value, job maintenance, and social support.

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