The Effect of Nerve-Sparing Robot-Assisted Radical Cystoprostatectomy on Erectile Function in a Preoperatively Potent Population

Haberman, Ken; Wittig, Kristina; Yuh, Bertram; Ruel, Nora; Lau, Clayton; Wilson, Timothy G.; Chan, Kevin

doi:10.1089/end.2014.0315

Cited by 17 publications

(8 citation statements)

References 22 publications

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“…Haberman et al and Asimakopoulos et al reported that 45% and 77.5% of patients, respectively, who received nerve-sparing RARC achieved potency. 17,18 Tyritzis et al showed that 74% and 88% of patients achieved daytime continence (1 pad per day) for 6 and 12 months, respectively, 19 whereas Asimakopoulos et al showed that 75% and 100% of patients experienced daytime continence (0 pad per day) for 1 and 12 months, respectively. 18 Recently, Kouk et al carried out single-port RARC with LND and intracorporeal ileal conduit in four patients with invasive bladder cancer.…”

Section: Surgical Techniquementioning

confidence: 99%

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Current status and future perspective of robot‐assisted radical cystectomy for invasive bladder cancer

Fujimura

2019

Int J of Urology

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The current status of robot‐assisted radical cystectomy was reviewed 16 years after the initial robot‐assisted radical cystectomy for the treatment of invasive bladder cancer. Articles associated with robot‐assisted radical cystectomy and written in English were selected from the PubMed database from January 2003 to February 2019. The present review article focused on the distribution of robot‐assisted radical cystectomy, patient selection, preoperative management, surgical technique, lymph node dissection, urinary diversion, recurrence pattern, oncological outcomes, cost, learning curve, complications and educational programs. A total of 400 articles were divided according to the country of the first author's affiliation. The USA was the most dominant at 198 (50%), whereas the number of articles from the countries belonging to the Urological Association of Asia was 15 (3.8%) for China, 17 (4.3%) for South Korea, 10 (2.5%) for Japan, eight (2%) for Taiwan, eight (2%) for Turkey and one (0.2%) for Iran. The percentage of robot‐assisted radical cystectomy carried out is increasing, and intracorporeal urinary diversion and ileal neobladder are also frequently carried out. With a refined technique being performed in high‐volume centers, robot‐assisted radical cystectomy has contributed to the reduction in transfusion rate, length of stay and severe complications; however, it has not yet shown any cancer‐specific survival benefits. Robot‐assisted radical cystectomy is not fully spread throughout the Urological Association of Asia. Further investigation with respect to worldwide results is needed to prove the real benefit of robot‐assisted radical cystectomy regarding low morbidity, reduced total medical cost, and survival benefit. In the era of precision medicine, appropriate drug and surgery will be given based on each genetic profile.

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Section: Surgical Techniquementioning

confidence: 99%

“…and Asimakopoulos et al . reported that 45% and 77.5% of patients, respectively, who received nerve‐sparing RARC achieved potency . Tyritzis et al .…”

Section: Introductionmentioning

confidence: 99%

Current status and future perspective of robot‐assisted radical cystectomy for invasive bladder cancer

Fujimura

2019

Int J of Urology

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“…As with radical prostatectomy, nerve sparing does help maintain sexual function. [102930] In a highly selected group, nerve sparing and seminal vesicle sparing may help preserve functional outcomes with over 70% reporting potency within 12 months of surgery; however, long-term oncological data are not available at this time, and this should be done with caution. [30] In addition, nerve sparing reports with short follow-up report oncologic outcomes are not compromised with this technique.…”

Section: Advances In Surgery For Muscle Invasive Bladder Cancermentioning

confidence: 99%

Advances in surgical management of muscle invasive bladder cancer

Kukreja

Shah

2017

Indian J Urol

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Introduction:Bladder cancer remains a disease of the elderly with relatively few advances that have improved survival over the last 20 years. Radical cystectomy (RC) has long remained the principal treatment for muscle-invasive bladder cancer (MIBC).Methods:A literature search of PubMed was performed. The content was reviewed for continuity with the topic of surgical advances in MIBC. Articles and society guidelines were included in this review.Results:Despite the associated morbidity, even in the elderly, RC is still a reasonable option. Modifications during RC may have a positive or negative impact on survival and quality of life. The extent of pelvic lymph node dissection is one such factor which may positively impact survival outcomes. In addition, preservation of pelvic organs, robotic surgery and the adoption of enhanced recovery after surgery principles continues to improve the postoperative recovery and quality of life in RC patients.Conclusion:There are some ongoing studies in many of these areas, but overall the new advances in MIBC may improve patient quality and quantity of life. The advances in surgical treatment of MIBC are important and the focus of the review here.

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“…During RC, the lateral portion of each bladder vascular pedicle is stapled with a vascular staple load, and a second staple load is used to divide the proximal portion of the posterior pedicle. Clips and athermal dissection are used to divide the distal portion of the posterior pedicle, staying close to the seminal vesicles, thereby avoiding undue damage to the erectile nerves that are in close proximity lateral to the seminal vesicles [9] , [16] . In addition, a more extended PLND should be performed in RC compared with RP, and the erectile nerves are at risk of injury when the lymph nodes in the presacral and internal iliac area are being removed [17] .…”

Section: Evidence Synthesismentioning

confidence: 99%

“…Nevertheless, the adoption of laparoscopic and robot-assisted technology has improved visualization and dexterity of pelvic surgeries. Several studies with varying results after nerve-sparing LRC have been published [8] , [9] , [10] . Herein we review the current available literatures concerning the anatomic basis, nerve-sparing techniques, and therapeutic effects of nerve-sparing LRC and RARC in male patients.…”

Section: Introductionmentioning

confidence: 99%

Current status of laparoscopic and robot-assisted nerve-sparing radical cystectomy in male patients

Huang

Fan

Dong

2016

Asian Journal of Urology

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During radical cystectomy (RC), the neurovascular bundles are easily removed or damaged, leading to varying rates of incontinence and erectile dysfunction. The nerve-sparing technique was developed to preserve urinary and erectile function. The adoption of laparoscopic and robot-assisted technology has improved visualization and dexterity of pelvic surgeries, thus facilitate the nerve-sparing technique. Although nerve-sparing RC is technically similar with nerve-sparing radical prostatectomy, there are still some anatomical differences. There are mainly three different types of nerve-sparing techniques. Pelvic lymph node dissection (PLND) is another important factor to influence erectile function and urinary continence. Nerve-sparing laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) may be an optimal treatment choice in well-selected younger patients with low-volume, organ-confined disease. We should attempt to do, whenever possible, a nerve-sparing cystectomy at least on oneside. However, due to the need of a well-refined surgical technique, nerve-sparing LRC and RARC is now being performed only by experienced urological surgeons.

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The Effect of Nerve-Sparing Robot-Assisted Radical Cystoprostatectomy on Erectile Function in a Preoperatively Potent Population

Cited by 17 publications

References 22 publications

Current status and future perspective of robot‐assisted radical cystectomy for invasive bladder cancer

Current status and future perspective of robot‐assisted radical cystectomy for invasive bladder cancer

Advances in surgical management of muscle invasive bladder cancer

Current status of laparoscopic and robot-assisted nerve-sparing radical cystectomy in male patients

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