Orthotopic bladder replacement in women: Focus on functional results of a retrospective, single-centre study

Pichler, Renate; Zangerl, Florian; Leonhartsberger, Nicolai; Stöhr, Brigitte; Horninger, Wolfgang; Steiner, Hannes

doi:10.3109/00365599.2012.738429

Cited by 15 publications

(8 citation statements)

References 42 publications

(42 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is cumulative data questioning the necessity of removing a long portion of the anterior vaginal wall, where orthotopic neobladder was possible in women with good oncological and functional outcome [ 6 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Survival up to 5–15 years in young women following genital sparing radical cystectomy and neobladder: oncological outcome and quality of life. Single–surgeon and single–institution experience

Wishahi¹,

Elganozoury²

2015

CEJU

View full text Add to dashboard Cite

IntroductionThis is an observational retrospective study utilising long term patient follow–up for 15 years to determine the survival and quality of life in women (age range 20–54 years) after having been treated for carcinoma of the bladder by radical cystectomy with preservation of genital organs.Material and methodsThe study included 13 female patients with urothelial carcinoma of the bladder treated with genital sparing radical cystectomy during the period of 1995 until 2006. They had orthotopic ileal neobladder. Follow–up included recurrence–free survival, metastases–free survival, overall survival, continence, and sexual function.ResultsGenital sparing cystectomy was done in 13 women. Seven women were between the ages of 20–37, and 6 women were aged 38–54. Overall survival of 10–15 years was 61.53%, survival from 5 to 9 years was 38.46%. The procedure was done in 9 women with a muscle–invasive tumor of stage T2– T3a. Non–muscle invasive T1 tumor was present in four patients. Quality of life was assessed by continence, which was good in 10/13 patients. Three women needed CIC. Sexual function was tested by female sexual function index >20–30 and was scored at 84.61%.ConclusionsThe study provides evidence of safety and efficacy of radical cystectomy with sparing of genital organs in women aged 20 to 54 with urothelial carcinoma of the bladder. Oncological outcome for 5–15 years was good; continence and sexual function were good. This procedure should be considered when surgical approach appears to be feasible. The limitation of our findings is the small sample size of this case series.

show abstract

Section: Introductionmentioning

confidence: 99%

Survival up to 5–15 years in young women following genital sparing radical cystectomy and neobladder: oncological outcome and quality of life. Single–surgeon and single–institution experience

Wishahi¹,

Elganozoury²

2015

CEJU

View full text Add to dashboard Cite

show abstract

“…The incidence of urethral (6.8%) and UUT (2.3%) recurrence after RC was consistent with previous findings. [4][5][6][7][8][9][10]16,19,31 We observed a statistical trend toward a lower rate of urethral recurrence after orthotopic reconstruction than after cutaneous diversion (5.7% vs. 8.1%). 5,7,24,29 The correct protocol and timing of surveillance after RC continue to be debated, with conflicting evidence reported.…”

Section: Discussionmentioning

confidence: 52%

Effect of Urinary Cytology for Detecting Recurrence in Remnant Urothelium After Radical Cystectomy: Insights From a 10-year Cytology Database

Pichler

Tulchiner

Oberaigner

et al. 2017

Clinical Genitourinary Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

“…Standard RC consisted of removal of the bladder, distal ureters and proximal urethra in both genders, including the prostate and seminal vesicles in men, and the adjacent vagina plus uterus in women 1 , 31 . The technique and outcome of “urethra-sparing” surgery in orthotopic ileal neobladder replacement for women have been described previously by our study group 16 ; the procedure includes the preservation of the sphincter mechanism and most of the lateral vaginal wall 16 . Extended bilateral pelvic lymphadenectomy was routinely performed in all patients as recommended and described by the EAU guidelines for muscle-invasive BC 1 , 31 .…”

Section: Methodsmentioning

confidence: 99%

“…Moreover, a delay of more than three months from diagnosis to RC may influence the oncological outcome negatively 10 - 11 . Delayed diagnosis would be one possible explanation for women with advanced tumor stage at the initial diagnosis 12 , resulting in higher rates of extravesical tumor disease at RC, and a delayed acceptance of orthotopic bladder substitution 13 - 16 . Nevertheless, the functional and long-term oncological outcome, and the postoperative quality of life after ileal neobladder in women were reported to be similar to those in men 16 - 18 .…”

Section: Introductionmentioning

confidence: 99%

“…Delayed diagnosis would be one possible explanation for women with advanced tumor stage at the initial diagnosis 12 , resulting in higher rates of extravesical tumor disease at RC, and a delayed acceptance of orthotopic bladder substitution 13 - 16 . Nevertheless, the functional and long-term oncological outcome, and the postoperative quality of life after ileal neobladder in women were reported to be similar to those in men 16 - 18 . Irrespective of gender, continent cutaneous diversion or the orthotopic neobladder was associated with lower rates of cancer-specific death 19 .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Gender-related Outcome in Bladder Cancer Patients undergoing Radical Cystectomy

Pichler¹,

Fritz²,

Heidegger³

et al. 2017

J. Cancer

Self Cite

View full text Add to dashboard Cite

Background: The impact of gender on oncological outcome after radical cystectomy (RC) is not fully understood yet. The aim of the study was to evaluate gender-related differences in histopathological parameters and prognosis of patients with bladder cancer undergoing RC.Methods: A retrospective analysis of a 10-year single-center cystectomy database was performed. Kaplan-Meier survival and Cox-regression analyses with sex-specific interactions were performed to determine the impact of gender on recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS), in addition to established clinicopathological factors.Results: 259 patients (212 [81.8%] men and 47 [18.2%] women) were enrolled. Although women had a greater propensity for extravesical (≥pT3) disease (53.2% vs. 33.9%, p=0.03) and heterotopic urinary diversion (72.3% vs. 49.5%, p=0.006), gender did not independently predict RFS, CSS or OS on multivariate analysis. Extravesical tumor disease was the sole independent predictor concerning RFS (hazard ratio [HR]=4.70; p<0.001), CCS (HR=2.77; p=0.013), and OS (HR=1.93; p=0.041). Orthotopic urinary diversion (HR=0.36; p=0.002) had an independent effect only on RFS. Rates of 5-year RFS (73.7% vs. 48.3%; p=0.001), CSS (72.5% vs. 44.9%; p<0.001) and OS (62.6% vs. 37.8%; p<0.001) were higher in orthotopic versus heterotopic diversions.Conclusion: In our series, women presented with more advanced tumors and higher rates of heterotopic urinary diversions, but their survival outcome was not significantly inferior to that of men. Extravesical disease was independently related to poorer survival after RC.

show abstract

Orthotopic bladder replacement in women: Focus on functional results of a retrospective, single-centre study

Abstract: Orthotopic bladder replacement is an efficient option in appropriately selected women undergoing radical cystectomy, with encouraging functional outcome and low urethral recurrence rates, similar to published literature in men.

Cited by 15 publications

References 42 publications

Survival up to 5–15 years in young women following genital sparing radical cystectomy and neobladder: oncological outcome and quality of life. Single–surgeon and single–institution experience

Survival up to 5–15 years in young women following genital sparing radical cystectomy and neobladder: oncological outcome and quality of life. Single–surgeon and single–institution experience

Effect of Urinary Cytology for Detecting Recurrence in Remnant Urothelium After Radical Cystectomy: Insights From a 10-year Cytology Database

Gender-related Outcome in Bladder Cancer Patients undergoing Radical Cystectomy

Contact Info

Product

Resources

About