Genital Sparing Cystectomy for Female Bladder Cancer and its Functional Outcome; a Seven Years' Experience with 24 Cases

Abstract

The surgical treatment of bladder cancer is the curative treatment especially in early cases. In this study, our aim was to assess the outcome of preservation of internal genital organs in selected females both oncologically and functionally, and to assess the feasibility of technique and its complication. 24 females with clinically and radiologically diagnosed T2 bladder cancer underwent gynecologic-tract sparing cystectomy (GTSC). Age ranged from 45 to 60 years. Patients with diffuse carcinoma-in-situ, those with tumors involving the bladder neck, those with poor general condition and those with preoperative incontinence were excluded. 1 patient, who developed local recurrence after 6 months. One patient lost follow up after 15 months. No recurrence developed in the retained genital organs. The remaining 20 patients remained free of disease. Among women who were eligible for functional evaluation, Daytime and nighttime continence were satisfactory in 21/22 (95.4 %) and in 20/22 (90.9 %) respectively. Chronic urinary retention, pouch-vaginal fistula was not noted. Most of patients showed superior Sexual Function index. Cystectomy with preservation of the internal genital organs is feasible in female with early, solitary or T2 bladder cancer with satisfactory functional and oncologic outcomes with proper case selection.

Genitalia Preserving Robotic Radical Cystectomy with Intracorporeal Studer Pouch Formation in the Female: Experience in 5 Cases

“…Salem et al reported the pathological findings of gynecologic organs obtained in female RC (n=250) performed for urothelial carcinoma. 3 Malignancy was identified in 1 uterus and 11 vagina specimens, including invasive urothelial carcinoma, all of which were clearly identified intraoperatively. They concluded that preservation of internal genitalia should be considered in selected cases after careful preoperative assessment.…”

“…Day time and night urinary continence rates were 95.4% and 90.2%, respectively. 3 Ali-El-Dein et al reported the outcomes of 15 female cases who underwent genitalia sparing open RC with orthotopic neobladder reconstruction. They included patients with clinical stage T2bN0M0 or less disease, unifocal tumors away from the trigone, sexually active young women and without any clinical suspicion of the involvement of internal genitalia by tumor.…”

“…Although an increasing number of publications exists in the literature related to robot-assisted laparoscopic radical cystectomy (RARC) in females, to date, very few authors have described gynecologic-tract sparing RARC. [1][2][3][4][5] Herein, we report surgical, oncologic and functional outcomes of five cases where we performed gynecologic-tract sparing RARC with intracorporeal Studer pouch reconstruction.…”

Orthotopic urinary diversions after radical cystectomy for bladder cancer: lessons learned last decade

“…Potency evaluation only included patients with potent erections preoperatively, and potency rates differed based on NS status with 10% (2/20) potent if no attempts at nerve sparing, 52% (42/81) if unilateral, and 72% (31/43) if bilateral NS [18]. Multiple studies suggest that uterine preservation and sparing the anterior vaginal wall can improve sexual function and is comparable to standard oncologic outcomes for radical cystectomy in well-selected female patients [19,20]. Women with bulky posterior wall tumors and cancer at the bladder base should be excluded from organ-sparing techniques given the higher chance for recurrence.…”

Robot‐assisted radical cystectomy: Review of surgical technique, and perioperative, oncological and functional outcomes

“…Cystectomy with preservation of the internal genital organs is feasible in women with early, solitary or T2 bladder cancer with satisfactory functional and oncological outcomes with proper case selection …”