Quality of life outcomes in patients of genitourinary tuberculosis undergoing major surgical procedures: A single center experience

Abstract

Objectives In India, an estimated 18% of patients suffering from tuberculosis (TB), have Genitourinary tuberculosis (GUTB). Understanding the effect of GUTB on overall health and QoL is essential for providing better patient care and modifying health programs. The present study was designed to provide insight into the change in QoL in GUTB patients following surgical management using the World Health Organisation Quality of Life Brief Version (WHOQOL-BREF) questionnaire. Material and Methods A total of 35 patients, who underwent extirpative or reconstructive surgery at our center from January 2016 to December 2021 were included. Demographic profiles, clinical details, laboratory data, radiological imaging findings, and microbiological data were recorded from our database. To assess the impact of the disease and the subsequent surgical treatment, patients themselves completed the WHOQOL-BREF Hindi questionnaires twice, based on the recall method. Results The mean age of the study cohort was 36.89±12.64 years. Lower urinary tract symptoms (LUTS) were the most common (68.6%) presenting symptoms. Kidney alone or in combination with other organs was involved in all but six cases, amongst them three cases each exclusively involved the ureter and bladder only. Isolated kidney was involved in 7/35 (20%) patients. Preoperative diversion of the upper tract was needed in 27 patients. Nephrectomy was the most commonly performed surgery (48.6%) overall. Ileal conduit with cystectomy was the most frequently performed reconstructive surgery (14.3%). Amongst all the domains, preoperative mean physical and environmental domain scores improved from 51.08 ± 12.39 to 57.71 ± 14.53 and 55.37 ± 13.41 to 64.02 ± 16.59 after surgery, respectively. Conclusion GUTB significantly affects all domains, psychological and physical being the worst affected facets. With surgical treatment, improvement in overall QoL and its domains could be achieved.