Clinical Outcome Following Prostatic Capsule- And Seminal-Sparing Cystectomy For Bladder Cancer In 25 Men

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 28 Dec 2008 - 1:00 PDT

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UroToday.com - In a recent article in the Scandinavian Journal of Urology and Nephrology, the authors evaluated the long-term outcomes of 25 men who underwent a prostate capsule- and seminal-sparing cystectomy. They hypothesized that this approach would improve continence and potency.

Twenty-five male patients underwent cystectomy with preservation of the seminal vesicles, posterior prostate and neurovascular bundles. Orthotopic neobladders were performed in all patients. At the time of last follow-up, patients were interviewed in a standard fashion to evaluate urinary, bowel and sexually related symptoms.

During the follow-up period (mean 72 months, range 33-129) five patients developed metastases and died of bladder cancer. Four men were diagnosed with concomitant prostate cancer. Complete day-time continence was reported in 17/20 (85%) patients. Complete nocturnal continence was seen in 10/20 (50%) men. A total of 20/21 (95%) were sexually active following prostate-sparing cystectomy.

The authors concluded that prostatic capsule- and seminal-sparing cystectomy appears to combine an acceptable oncological outcome with satisfactory function of the lower urinary tract. A significant problem is that 4 out of 25 men developed, or were diagnosed with prevalent prostate cancer. If prostate capsule-sparing surgery is contemplated, preoperative prostate biopsies are needed to exclude the presence of prostate cancer.

Thorstenson A, Corey O'Connor R, Ahonen R, Jonsson MN, Wijkstrom H, Akre O, Hosseini A, Peter Wiklund N, Henningsohn L
Scand J Urol Nephrol. 2008 Nov 27:1-6

Written by UroToday.com Contributing Editor David P. Wood, MD

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