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Ailments associated with surgical technique of nephroureterectomy - patients opinion
Article published in Urologia Polska 2005/58/2.

authors

Bartosz Dybowski, Maciej Czaplicki, Andrzej Borkowski
Katedra i Klinika Urologii Akademii Medycznej w Warszawie
Kierownik kliniki: prof. dr hab. Andrzej Borkowski

keywords

nephroureterectomy, lateral paramedian incision, quality of life, chronic pain, hernia

summary

introduction and objectives
The aim of the present study is to compare ailments occurrence in patients subjected to nephroureterectomy performed through one incision (paramedian) or through two incisions (flank with median or oblique inferior).
material and methods
There were 44 nephroureterectomies performed from 1996 to 2002. 29 living in January 2003 patients were asked to fulfill the questionnaire consisted of 10 questions considering ailments associated with operated are, presence of hernia and their influence on quality of life. 26 patients gave the answers: 11 of them were operated through paramedian incision (mean age 70 years) and 15 of them through two incisions (mean age 65.6 years).
results
Among patients operated through one incision 6 presented symptoms (54.5%) and 1 had hernia. Symptoms had significant influence on quality of life in one patient. Scar appearance was estimated as very good, good and ordinary by 4,5 and 2 patients respectively. Among patients operated through two incisions 8 presented symptoms associated with the scar (53.3%), 3 had hernia. Symptoms significantly influenced daily activities in 3 patients. Scar appearance was estimated as very good, good and ordinary by 4,7 and 3 patients respectively. There was no statistical significance between the groups of patients. Ailments and lower quality of life were more frequently presented by younger patients: 9 out of 11 before 66 years of age and 5 out of 15 elder patients (p=0.04). The most frequent symptoms were: pain, twinges and stiffens. Symptoms withdrew after 3-6 months in 9 out of 14 patients.
conclusions
Both methods of nephroureterectomy are burdened with increased risk of ailments associated with nerves injury, but its occurrence does not depend on surgical technique. Younger patients are more susceptible for decrease in quality of life and ailments presentation.

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correspondence

Bartosz Dybowski
Klinika Urologii AM
ul. Lindleya 4
02-005 Warszawa
tel. (022) 502 15 16, fax (022) 502 21 48
bardyb@poczta.onet.pl