Preservation of the Anterior Vaginal Wall During Female Radical Cystectomy With Orthotopic Urinary Diversion: Technique and Results

Chang, Sam S.; Cole, Emily E.; Cookson, Michael S.; Peterson, Matthew; Smith, Joseph A.

doi:10.1016/s0022-5347(05)64470-9

Cited by 88 publications

(30 citation statements)

References 14 publications

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“…In women, in selected cases, the classical anterior exenteration may be modified to allow sparing of the uterus, ovaries and vagina, with nerve-sparing and preservation of the urethra for orthotopic reconstruction, with retention rather than incontinence being the major issue. In selected cases preserving the entire vaginal wall is feasible but it remains unclear whether this results in better continence and sexual function [4]. In men, nerve-sparing techniques have allowed highly selected patients to maintain potency.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic radical cystectomy and urinary diversion: fad or future?

Hrouda¹,

Adeyoju²,

Gill³

2004

BJU International

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Section: Introductionmentioning

confidence: 99%

Laparoscopic radical cystectomy and urinary diversion: fad or future?

Hrouda¹,

Adeyoju²,

Gill³

2004

BJU International

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“…Orthotopic neobladder replacement has now been established as an acceptable and desirable type of urinary diversion in a significant percentage of female patients. [8,9].There is an evidence indicating that in female patients who fulfill the criteria for such procedure, preserving the vaginal wall during cystectomy with subsequent orthotopic neobladder reconstruction significantly decreases the risk of neobladdervaginal fistula and might improve the functional results [3,10] In our series, none of the patients developed neobladdervaginal fistula with maintained plane between the posterior bladder wall and the anterior vagina. Moreover, preserving the gynecologic organs and pubourethral ligament is less likely to result in pelvic descent or prolapse.…”

Section: Discussionmentioning

confidence: 57%

“…Achieving an excellent functional response at the expense of compromising cancer cure is not acceptable and it is important to provide patients with the best possible functional outcome, as there is an obvious effect of poor urinary function on the quality of life [7]. The aim of orthotopic bladder reconstruction is to provide a compliant, low pressure continent urinary reservoir that may be emptied completely at socially convenient intervals [3]. Orthotopic neobladder replacement has now been established as an acceptable and desirable type of urinary diversion in a significant percentage of female patients.…”

Section: Discussionmentioning

confidence: 99%

“…The patient was placed in the supine position. An eighteen Folly's catheter was passed and the balloon was inflated to 20 cm 3 . A betadine soaked pack was inserted in the vagina.…”

Section: Surgical Procedures (Figs 1 and 2)mentioning

confidence: 99%

“…There is a Considerable interest to preserve the gynecologic tract during cystectomy without affecting the oncologic outcome to maintain the sexual function [2]. Young females with bladder cancer have a desire to preserve the uterus and adnexa for retaining the reproductive function [3]. The oncologic principle of routine removal of the internal genital organs during cystectomy has been questioned.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Roshdy

Senbel

Khater

et al. 2015

Indian J Surg Oncol

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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.

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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

show abstract

Preservation of the Anterior Vaginal Wall During Female Radical Cystectomy With Orthotopic Urinary Diversion: Technique and Results

Cited by 88 publications

References 14 publications

Laparoscopic radical cystectomy and urinary diversion: fad or future?

Laparoscopic radical cystectomy and urinary diversion: fad or future?

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

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

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