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    Some post-cystectomy symptoms persist for 3 months

    Constipation, depression, sleep disturbances among lingering symptoms

    New research suggests that post-surgery symptoms may last for at least 3 months in cystectomy patients and worsen over time in some cases, posing unique management challenges for urologists.

    Pain, anxiety, and depression; constipation; diarrhea; nausea; and sleep disturbances were all common, researchers found. Patients may also suffer from difficulties with social functioning and walking. The findings were presented at the 2016 American College of Surgeons Clinical Congress in Washington.

    Angela B. Smith, MD, MSDr. Smith"The percentage of patients who experienced constipation throughout the 3-month time period was surprising, as was the percentage with sleep [disturbance] and fatigue persisting over 3 months," said study co-author Angela B. Smith, MD, assistant professor of urology at the University of North Carolina at Chapel Hill.

    The good news, she told Urology Times, is that the study findings will help urologic surgeons provide patients with more accurate information about symptoms.

    Also see: What is the biggest stressor in your office?

    "Fear of the unknown can be a big challenge for patients, so it can be helpful to know that there is an endpoint in sight with regard to certain symptoms,” she said.

    "In general, patients take quite a long time to recover," Dr. Smith said. "We know that there are a number of postoperative symptoms like nausea, vomiting, GI distress, fatigue, and sleep disturbances. But we really don't have a good sense of how many experience each symptom and at what time points."

    In her practice, she said, patients often ask about when they'll experience symptoms and when they'll improve. But, she said, "I didn't have a good answer to guide them."

    For the new study, Dr. Smith and colleagues administered a phone survey to 27 patients who underwent cystectomy in 2014 and 2015. The patients answered questions weekly for 30 days and biweekly for the rest of the time up to 12 weeks. The participants completed a median of seven calls.

    Some patients reported pain throughout the entire 3 months, with the highest level (29%) at week 2.

    "Then they had a steep drop-off at 3 weeks," Dr. Smith said. This was expected, as patients begin to recover over time, she said.

    Next: Decreased appetite seen in early weeks

    Randy Dotinga
    Randy Dotinga is a medical writer based in San Diego, Calif.

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