Transprostatic Selective Cystectomy with an Ileal Bladder

Schilling, A.; Friesen, A

doi:10.1159/000463924

Cited by 30 publications

(8 citation statements)

References 2 publications

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“…The only patient in Moutzouris' series to develop recurrence was one in whom the prostatic apex had been preserved during orthotopic neobladder reconstruction. Some authors have suggested preserving the apical prostatic urethra to make the urethro-neobladder anastomosis technically easier, with improved continence and erectile function [10,11] . However, this compromises the basic oncological principles; fi rstly 60% of incidental prostate cancers involve the prostatic apex, of which 70% are clinically signifi cant; secondly, the incidence of fi nding TCC/ carcinoma in situ in the prostatic urethra in patients undergoing cystectomy for bladder cancer ranges from 27 to 48% [8] .…”

Section: Discussionmentioning

confidence: 99%

Incidentally Detected Prostate Cancer in Cystoprostatectomy Specimens

et al. 2005

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Objectives: Bladder and prostate cancers occur with increasing prevalence in the ageing population. Our study aims to quantify the incidence of prostate cancer in patients undergoing cystoprostatectomy for bladder cancer and assess the impact of that incidental prostate cancer on oncological outcome. Methods and Materials: We retrospectively reviewed the pathology reports of 128 men who underwent cystoprostatectomy for bladder cancer. Results: Twenty-three men (18%) were found to have incidental prostate cancer. All incidental prostate cancers were organ confined and 91% were well or moderately differentiated. At a mean follow-up of 55 months the prostate cancer-free survival was 96%. Conclusion: The incidence of prostate cancer in cystoprostatectomy specimens is high. When the prostate is removed completely the presence of incidental prostate cancer does not influence the overall oncological outcome.

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Section: Discussionmentioning

confidence: 99%

Incidentally Detected Prostate Cancer in Cystoprostatectomy Specimens

et al. 2005

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“…After nerve‐sparing cystoprostatectomy, introduced by Walsh and Mostwin in the mid‐1980s [9], over half of the patients still lost potency [10]. To improve the potency results, prostate‐sparing cystectomy (PSC) was then introduced, and the initial findings reported were excellent in terms of erectile function and urinary continence [11]. PSC was further developed to spare not only the prostate but also the seminal vesicles [12–14].…”

Section: Introductionmentioning

confidence: 99%

Prostatic capsule‐ and seminal‐sparing cystectomy for bladder carcinoma: initial results for selected patients

et al. 2004

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OBJECTIVE To evaluate the oncological outcome and functional results of prostate‐sparing cystectomy (PSC), proposed for treating bladder cancer, used since 1999 in our institution in an attempt to preserve male sexuality and to increase continence after cystectomy. PATIENTS AND METHODS Between January 1999 and December 2001, 111 men were candidates for cystectomy; 42 were selected for a prostatic capsule‐ and seminal‐sparing cystectomy with orthotopic urinary diversion. All patients had clinically organ‐confined tumours (clinical stage ≤ T2, N0M0). The first stage of the procedure was a transurethral resection of the prostate to exclude the involvement of transitional cell carcinoma (TCC) in the prostate. RESULTS Eight patients were excluded from PSC because they had TCC (seven) or prostate adenocarcinoma (one). The mean age of the remaining 34 patients was 61 years and all underwent PSC. After a mean follow‐up of 26 months, seven patients (21%) had a recurrence; one developed a local recurrence, there were widespread metastases in six (18%), and five had histologically confirmed organ‐confined tumour (T1‐2N0M0). Rates for daytime and night‐time continence were 90% and 85%, and in 29 patients potency was unchanged. CONCLUSION These early results suggest that PSC is not equivalent to radical cystoprostatectomy for bladder cancer control, despite marked improvements in the functional results. Moreover, in carefully selected patients this approach appears to dramatically increase an unusually high metastasis rate. Therefore, the indications for PSC should be either clearly well defined or abandoned in these patients.

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“…Two broad categories of nerve‐sparing (NS) surgery have been developed to overcome these functional limitations: NS cystoprostatectomy (NSCP) first described by Schlegel and Walsh [4] in 1987, and prostate capsule‐sparing cystectomy (PCSC), which was first described by Schilling and Friesen in 1990. Urothelial carcinoma is considered a lethal disease and oncological outcomes are paramount to quality‐of‐life considerations.…”

Section: Introductionmentioning

confidence: 99%

Long‐term functional and oncological outcomes of nerve‐sparing and prostate capsule‐sparing cystectomy: a single‐centre experience

et al. 2019

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ObjectivesTo evaluate the technical feasibility, oncological and functional outcomes of nerve sparing cystoprostatectomy (NSCP) and prostate capsule-sparing cystectomy (PCSC) for the treatment of organ-confined bladder cancer at a single referral centre. , 60 patients underwent PCSC and 47 were treated with NSCP. Inclusion criteria for PCSC were: fully informed consent for the well-motivated patient; negative transurethral resection of the bladder neck; normal prostatic specific antigen (PSA) level (defined as <4 ng/dL during the first year of the study, which was later lowered to 2.5 ng/dL); and normal transrectal ultrasonography, with biopsy for any suspicious nodule. Patients received a complete oncological and functional follow-up. The Kaplan-Meier method was used to depict survival outcomes after surgery. ResultsAfter a median follow-up of 73 and 62 months for PCSC and NSCP, respectively, the 5-year cancer-specific survival was 90% for the PCSC group and 78% for the NSCP group (P = 0.055). Considering complications within 30 days after surgery, 13% and 21% patients had Clavien ≥III complications in the PCSC and NSCP groups, respectively (P = 0.2). For functional outcomes, at 3 months after surgery, 54 (90%) and 24 (51%) patients reported full recovery of daytime urinary continence in the PCSC and NSCP groups, respectively (P < 0.001); and for erectile function recovery, 32 (53%) and four (9%) patients in the PCSC group and in the NSCP group were respectively potent without any treatment (P < 0.001). ConclusionsNSCP and PCSC are appropriate for a subset of patients with bladder cancer, with excellent oncological and functional results. These surgical procedures should be proposed to wellmotivated patients.

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Transprostatic Selective Cystectomy with an Ileal Bladder

Cited by 30 publications

References 2 publications

Incidentally Detected Prostate Cancer in Cystoprostatectomy Specimens

Incidentally Detected Prostate Cancer in Cystoprostatectomy Specimens

Prostatic capsule‐ and seminal‐sparing cystectomy for bladder carcinoma: initial results for selected patients

Long‐term functional and oncological outcomes of nerve‐sparing and prostate capsule‐sparing cystectomy: a single‐centre experience

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