Orthotopic genital sparing radical cystectomy in pre-menopausal women with muscle-invasive bladder carcinoma: A prospective study

Abstract

Introduction:Invasive cancer bladder is a life-threatening disease that is best treated with radical cystectomy and a suitable urinary diversion. The aim of this study was to evaluate the oncological outcome, voiding and sexual functions after genital sparing radical cystectomy with orthotopic bladder reconstruction in pre-menopausal women with bladder cancer.Materials and Methods:18 pre-menopausal women who underwent radical cystectomy and orthotopic urinary diversion with preservation of genital organs were included for this study. The patients were followed-up clinically and radiologically to assess their oncological outcome in addition to their voiding and sexual function.Results:Mean age of the patients was 37.8 years, and the median follow-up after surgery was 70 months. One patient was lost to follow-up at 12 months post-operatively. The surgery was completed as planned in all patients, with a mean operative time of 290 min and an average blood loss of 750 mL. 14 patients were able to void satisfactorily, being continent day and night, while four patients needed clean intermittent catheterization. Sexual life remained unchanged in 15 cases, while three patients reported dysparunea. Till the last follow-up, there was no local recurrence while distant metastases were detected in three cases, two of whom died.Conclusions:Genital sparing cystectomy is a valid option for managing carefully selected women with muscle-invasive bladder cancer with good functional and sexual outcomes.

Systematic review of the oncological and functional outcomes of pelvic organ‐preserving radical cystectomy (RC) compared with standard RC in women who undergo curative surgery and orthotopic neobladder substitution for bladder cancer

“…). In all, 11 937 articles were identified and screened; of these, 16 articles were eligible for full‐text screening and 15 met the inclusion criteria .…”

“…Data were available for 874 patients from the 15 studies. Table outlines the baseline characteristics of the included studies, including the exclusion criteria reported by the authors. Common practice in studies was to exclude patients with bladder tumour involving the trigonal area or bladder neck.…”

“…We reviewed 12 retrospective case series . The largest study recruited 86 patients , whilst the smallest study recruited three patients only .…”

“…The age of patients ranged from 42 to 77 years and the pathological stages were not reported. A third group of studies reported the results of genital‐sparing RC . There was a large variation in the age of the patients (20–80 years) and pathological bladder ≥T3 stage (7.7–100%).…”

“…Figure presents the RoB assessment for the NRCS, and Fig. for single‐arm case series. The overall RoB for the NRCS was high or unclear, with all studies judged to have high confounding bias across most confounders.…”