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[Modified cystectomy with preservation of erectile and ejaculatory functions in men with nonmalignant bladder
Min Ye1, Wei-Ming Wang, Ying-Jian Zhu
1Department of Urology, Xinhua Hospital of Shanghai Second Medical University, Shanghai 200092, China.
Objectives:
To evaluate modified cystectomy with preservation of erectile and ejaculatory functions in men with nonmalignant bladder disease.
Methods:
Seven cases with average age of 27 years presented with bladder disease necessitating cystectomy, including 2 cases of tuberculous contractile bladder, 1 case of extensive polypoid cystitis glandularis, 4 cases of late stage of neurogenic bladder. All patients wished to maintain erectile and ejaculatory functions after the operation. We performed a modified simple cystectomy with preservation of the vasa deferens, seminal vesicles, prostate and neurovascular bundles, as well as construction of an Indiana pouch or ileal neobladder.
Results:
Average operative time was 5 h 45 min without perioperative complications in this group. Follow-up ranged from 9 to 60 months. Erectile and ejaculatory functions were normal in all cases. All patients remained completely continent and no dysuria in neobladder, and there was no difficulty in inserting catheter to empty pouch. Upper urinary tract was in good condition 3 and 24 months after operation.
Conclusions:
Modified cystectomy with preservation of the vasa deferens, seminal vesicles, prostate and neurovascular bundles is an effective and reliable option for the patients who wish to maintain their fertility and erectile function after surgery.