Prostate-Sparing Radical Cystectomy for Selected Patients with Bladder Cancer

Abstract

Objectives: To review the current literature about prostate-sparing radical cystectomy (PSRC) and its potential for management of a selected population of patients with bladder cancer. Materials and Methods: The PubMed, EMBASE and Scopus databases were searched for the key words ‘prostate', ‘sparing' and ‘cystectomy' between 1984 and 2012. Articles in English, French and German were considered relevant for review. Institutional experience with this procedure was also included. Results: PSRC remains a controversial procedure for the treatment of patients harboring bladder carcinoma, mainly due to insufficient knowledge of clear indications and/or contraindications. Experience with PSRC is still limited to very few referral centers and there is a lack of large series with long-term outcomes. The potential for excellent functional outcomes must be carefully balanced against inconsistent oncological results. Conclusions: PSRC may become an option for carefully selected and extensively informed patients. Suggestions for possible indications and contraindications are presented.

Prognostic Significance of Incidental Prostate Cancer at Radical Cystoprostatectomy for Bladder Cancer

“…As in our centers the diagnostic work-up with PSA and DRE was usually done a few days prior to RC, the treatment approach did not change for patients with suspicious findings. However, with regard to studies advocating prostate-sparing techniques to improve functional outcomes after RC [7,20], our findings confirm the current clinical practice to use these parameters in order to rule out the presence of significant PC at RC.…”

Fifteen-year single-centre experience with three different surgical procedures of nerve-sparing cystectomy in selected organ-confined bladder cancer patients

“…Interestingly, the overall rate of NS-RC was less than 9 %, and this rate has not changed during the time, showing that the growth of this surgery, in addition to the reasonable oncologic concerns [19,20], suffers from intrinsic limitations mainly related to the restricted clinical indications and the surgical complexity. Up to now, only a few referral centres [21][22][23] declared the rate of their NS-RCs, while there is no mention at all in the literature about the weight of this surgery in peripheral urologic centres making any comparison unsuitable. Over the time, the distribution of the different techniques used at our centre reflects the knowledge progressively acquired in the neuroanatomy field and in the refinement of the surgical technique that allowed for a remodelling of the original surgical approach.…”

Successful Pregnancy and Neobladder Subsequent to Muscle Invasive Bladder Cancer and Fertility Preserving Surgery: Case Report and Review of the Literature

“…Thus, prostate-sparing modifications for carefully selected patients (e.g. young age, normal prostate-specific antigen, negative digital rectal examination, negative prostate biopsy) preserving their sexual function are also considerable but still controversial [13]. …”