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Decision Regret Related to Urinary Diversion Choice among Patients Treated with Cystectomy.

Publication ,  Journal Article
Check, DK; Leo, MC; Banegas, MP; Bulkley, JE; Danforth, KN; Gilbert, SM; Kwan, ML; Rosetti, MO; McMullen, CK
Published in: J Urol
January 2020

PURPOSE: Patients who undergo cystectomy due to bladder cancer can elect an ileal conduit or a neobladder for urinary diversion. Decision regret related to this choice is an important and undesirable patient reported outcome. Our objective was to compare the severity of decision regret experienced by patients with a neobladder vs an ileal conduit. MATERIALS AND METHODS: We analyzed data from a longitudinal cohort study of patients who underwent cystectomy from 2013 to 2015. We applied multivariable linear regression to examine associations of the urinary diversion method (neobladder vs ileal conduit) with decision regret measured with the DRS (Decision Regret Scale) 6 and 18 months after cystectomy. Covariates included demographic and clinical characteristics, health care utilization and complications after cystectomy, quality of life and factors related to the decision making process, including informed and shared decision making, and goal concordance. RESULTS: Of the 192 patients in our cohort 141 received an ileal conduit and 51 received a neobladder. We observed no significant difference in the DRS score in patients with a neobladder vs an ileal conduit at 6 or 18 months (b=-1.28, 95% CI -9.07-6.53, vs b=-1.55, 95% CI -12.48-9.38). However, informed decision making was negatively related to decision regret at 6 and 18 months (b=-13.08, 95% CI -17.05--9.11, and b=-8.54, 95% CI -4.26--2.63, respectively). Quality of life was negatively associated with decision regret at 18 months (b=-5.50, 95% CI -8.95--2.03). CONCLUSIONS: Patients treated with cystectomy who were more informed about bladder reconstruction options experienced less regret independent of the method selected. Efforts to inform and prepare patients for the bladder reconstruction decision may help prevent decision regret.

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Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

January 2020

Volume

203

Issue

1

Start / End Page

159 / 163

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Diversion
  • Urinary Bladder Neoplasms
  • Quality of Life
  • Patient Satisfaction
  • Patient Reported Outcome Measures
  • Neoplasm Invasiveness
  • Middle Aged
  • Male
  • Longitudinal Studies
 

Citation

APA
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Check, D. K., Leo, M. C., Banegas, M. P., Bulkley, J. E., Danforth, K. N., Gilbert, S. M., … McMullen, C. K. (2020). Decision Regret Related to Urinary Diversion Choice among Patients Treated with Cystectomy. J Urol, 203(1), 159–163. https://doi.org/10.1097/JU.0000000000000512
Check, Devon K., Michael C. Leo, Matthew P. Banegas, Joanna E. Bulkley, Kim N. Danforth, Scott M. Gilbert, Marilyn L. Kwan, Maureen O’Keeffe Rosetti, and Carmit K. McMullen. “Decision Regret Related to Urinary Diversion Choice among Patients Treated with Cystectomy.J Urol 203, no. 1 (January 2020): 159–63. https://doi.org/10.1097/JU.0000000000000512.
Check DK, Leo MC, Banegas MP, Bulkley JE, Danforth KN, Gilbert SM, et al. Decision Regret Related to Urinary Diversion Choice among Patients Treated with Cystectomy. J Urol. 2020 Jan;203(1):159–63.
Check, Devon K., et al. “Decision Regret Related to Urinary Diversion Choice among Patients Treated with Cystectomy.J Urol, vol. 203, no. 1, Jan. 2020, pp. 159–63. Pubmed, doi:10.1097/JU.0000000000000512.
Check DK, Leo MC, Banegas MP, Bulkley JE, Danforth KN, Gilbert SM, Kwan ML, Rosetti MO, McMullen CK. Decision Regret Related to Urinary Diversion Choice among Patients Treated with Cystectomy. J Urol. 2020 Jan;203(1):159–163.
Journal cover image

Published In

J Urol

DOI

EISSN

1527-3792

Publication Date

January 2020

Volume

203

Issue

1

Start / End Page

159 / 163

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urinary Diversion
  • Urinary Bladder Neoplasms
  • Quality of Life
  • Patient Satisfaction
  • Patient Reported Outcome Measures
  • Neoplasm Invasiveness
  • Middle Aged
  • Male
  • Longitudinal Studies