[Radical cystectomy with sparing partial prostate for invasive bladder cancer]

Area of Science:

• Urology
• Oncology

Context:

• Radical cystectomy for invasive bladder cancer traditionally involves complete prostate removal, leading to significant post-operative sexual dysfunction and incontinence.
• The necessity of prostate excision when the tumor is not involved remains unclear, prompting investigation into prostate-sparing techniques.

Purpose:

• To evaluate the feasibility and outcomes of radical cystectomy with partial prostate sparing in male patients with invasive bladder cancer.
• To assess the impact of preserving prostate tissue on tumor control, urinary continence, and sexual function.

Summary:

• Ten male patients with invasive bladder transitional cell carcinoma underwent transurethral resection and radical cystectomy with partial prostate sparing, followed by intestinal neobladder reconstruction.
• Postoperative evaluation at a mean of 9 months showed T2N0M0 staging in all patients, with 90% disease-free survival.
• All patients experienced smooth voiding, with 90% achieving day and night urinary continence, and 75% (6 of 8) maintaining sexual potency.

Impact:

• Radical cystectomy with partial prostate sparing demonstrates potential for preserving urinary control and sexual potency.
• These findings suggest that prostate-sparing cystectomy is a viable option for select patients, potentially improving quality of life.
• Further long-term studies are necessary to confirm the oncological safety and efficacy of this approach.