Seminal-sparing Cystectomy: Technical Evolution and Results Over a 20-Year Period

Muto, Giovanni; Collura, Devis; Rosso, Rodolfo; Giacobbe, Alessandro; Muto, G.; Castelli, Emanuele

doi:10.1016/j.urology.2013.08.093

Cited by 11 publications

(20 citation statements)

References 17 publications

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“…Even with retrospective data, despite the technique having been practiced since the early 1990s, the total worldwide number of published PCSC cases is <500. In fact, only four institutions have reported long‐term outcomes for ≥50 cases . Oncological skepticism has traditionally been based on three arguments: (i) ~20% of bladder cancer specimens have invasion into the prostate at the time of RC ; (ii) ~30% of all patients with bladder cancer have occult prostate cancer ; and (iii) the incidence of local and distant failure in PCSC series is presumed to be higher.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, it appears from our work that PCSC is functionally superior to NSCP. Looking separately in the literature at both techniques, most NSCP authors reported daytime continence rates of 77–98%, nocturnal continence rates of 54–95%, and potency rates of 33–63% , whilst authors advocating for prostate sparing reported daytime continence rates of 80–100%, nocturnal continence rates of 37–100%, and potency rates of 82–100% .…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…The primary goal of laparoscopic prostate-sparing cystectomy for bladder cancer in our series is to optimize postoperative functional results for continence and sexual function while always preserving the oncological principles. Continence rates following prostate sparing cystectomy are impressive in most series [ 14 , 15 , 16 ]. In our patients after catheter removal, daytime continence was achieved in 65%, and night-time continence in 50%.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic radical cystectomy with prostate capsule sparing. Initial experience

Rivas

Gregorio

Gómez

et al. 2016

CEJU

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IntroductionIn 2008, our department introduced a modified technique of laparoscopic radical cystectomy in which the prostatic capsule is spared in selected patients with bladder cancer. The different series published are mostly using the standard open procedure. The aim of this study is to describe this technique using the laparoscopic approach and present our preliminary results.Material and methodsThis study includes 20 patients selected by clinical analysis and imaging criteria operated using laparoscopic radical cystectomy with prostate capsule sparing at our department in the period between 2008 and 2012.ResultsPatient mean age was 58 years. Mean operative time was 390 minutes. Median follow-up was 36 months. No patient had bladder cancer recurrence. Only one patient died of disease progression, as the pathological findings was a pT3 pN1 Mx. Mean PSA before surgery: 1.3 ng/ml (03–2), mean PSA after surgery 1.0 ng/ml (0.08–1.7). No patients had prostate cancer recurrence. Satisfactory daytime and night-time continence was achieved. 90% of patients have sexual function preserved.ConclusionsProstate-sparing radical cystectomy remains one of the most controversial topics in urology today. The laparoscopic approach could be an alternative to conventional radical cystoprostatectomy in well selected patients, done in experienced institutions in order to find better functional results, with a low disease progression and recurrence rate.

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“…Eight studies reported on nerve-sparing cystectomy, 24,[26][27][28][29]34,38,40 seven on prostate-sparing cystectomy, 9,25,32,36,38,42,43 four on capsule-sparing cystectomy 24,29,30,41 and two on seminal vesicle-sparing cystectomy. 29,31 There were a total of 305 female patients included across five studies [33][34][35]37,39 ; four of which were female-only studies. 33,35,37,39 Three of these studies reported on nerve-sparing cystectomy, [33][34][35]37 whereas two studies also documented uterus sparing and uterus, vagina, ovary and fallopian tube-sparing techniques, respectively.…”

Section: Study Characteristicsmentioning

confidence: 99%

Oncological and functional outcomes of organ‐preserving cystectomy versus standard radical cystectomy: A systematic review and meta‐analysis

et al. 2022

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Introduction: Radical cystectomy (RC) is historically considered the gold standard treatment for muscle invasive and high-risk non-muscle invasive bladder cancer.However, this technique leaves the majority of patients of both sexes with poor sexual and urinary function. Organ-sparing cystectomy (OSC) techniques are emerging as an alternative to the standard procedure to preserve these functions, without compromising the oncological outcomes. We present a systematic review and metaanalysis of the published literature.Methods: MEDLINE, Embase and Web of Science were systematically searched for eligible studies on 6 April 2021. Primary outcomes studied were both oncological outcomes, specifically overall recurrence, and functional outcomes, specifically sexual function, and daytime and nighttime continence. Odds ratios (OR) with 95% confidence intervals (95% CI) were calculated. The PROSPERO registration reference number was CRD42018118897.Results: From 13 894 identified abstracts, 19 studies (1886 male and 305 female patients) were eligible for inclusion in this review. These studies included patients who underwent either whole prostate, prostate capsule, seminal vesicle, nerve, uterus, ovary, vagina and fallopian tube sparing techniques. Four studies included only female patients.Thirteen studies reported oncological outcomes, and overall recurrence rate was similar between the two groups (five studies; OR 0.73; 95% CI 0.38-1.40, p = 0.34).Thirteen studies reported on male sexual function. In men, OSC had significantly

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Seminal-sparing Cystectomy: Technical Evolution and Results Over a 20-Year Period

Cited by 11 publications

References 17 publications

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

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

Laparoscopic radical cystectomy with prostate capsule sparing. Initial experience

Oncological and functional outcomes of organ‐preserving cystectomy versus standard radical cystectomy: A systematic review and meta‐analysis

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