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Patients with an IC suffered more often from locally advanced disease (\u2265\u2009pT3; 41.4% vs. 24.1%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and lymph node metastases (19.9% vs. 11.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), resulting in worse probability of survival (p\u2009&lt;\u20090.001). Global HRQoL improved steadily during follow-up, but significant differences in subscales persisted between cohorts. Multivariable regression analysis identified IC, male sex, and patient age\u2009\u2264\u200959 years as independent predictors for persistent high psychosocial distress. Almost 42% of female patients reported severe urinary incontinence two years after RC. Most men reported severely diminished erectile function, even after nerve-sparing surgery.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Global HRQoL two years after RC is comparable to the general German population. Female patients should be informed about worse continence rates. Conversely, men should be educated about erectile dysfunction. Aftercare should include psycho-oncologic counseling, especially for patients at risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for cancer survivors<\/jats:title>\n                    <jats:p>Patients should be counseled on long-term functional outcomes and persistent psychosocial distress after RC. Closer cooperation between urologists and psycho-oncologists is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11764-024-01535-0","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T14:02:24Z","timestamp":1706623344000},"page":"1102-1110","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["A prospective evaluation of quality of life, psychosocial distress, and functional outcomes two years after radical cystectomy and urinary diversion in 842 German bladder cancer patients"],"prefix":"10.1007","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5768-0364","authenticated-orcid":false,"given":"Henning","family":"Bahlburg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Reicherz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz","family":"Reike","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius Cristian","family":"Butea-Bocu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl Heinrich","family":"Tully","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Roghmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Noldus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"M\u00fcller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,30]]},"reference":[{"key":"1535_CR1","doi-asserted-by":"publisher","first-page":"1715","DOI":"10.1007\/s00345-022-04017-z","volume":"40","author":"L Flegar","year":"2022","unstructured":"Flegar L, Kraywinkel K, Zacharis A, Aksoy C, Koch R, Eisenmenger N, et al. 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