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

Classical radical cystectomy for invasive bladder cancer removes the urinary bladder and prostate completely and was associated with high incidence of post-operative impotence and urinary incontinence. It is uncertain whether prostate excision has any effects on the prognosis of patients undergone cystectomy if the prostate is not involved by the tumor. Sparing the prostate in radical cystectomy might improve potency and urinary control. This paper was to report our experience of sparing partial prostate in radical cystectomy for ten male patients.

Transurethral resection of the prostate and radical cystectomy with sparing partial prostatic capsula were carried out in 10 male patients with invasive bladder transitional cell carcinoma. Intestinal neobladder, anastomosed with the residual capsula, were used for reconstruction of the lower urinary tract. Clinical outcome of these patients including tumor control,urinary continence, and sexual status was evaluated.

Mean follow-up was 9 months (range 3-12 months). Postoperative pathological stage was T2N0M0 in all patients. Nine patients survived free of disease. One patient who had recurrence of poorly differentiated transitional cell carcinoma developed metastasis in bone and lymph nodes two months after cystectomy. All patients voided smoothly. Nine patients were continent day and night. One patient had mild incontinence. Of 8 patients with previously sexual function, 6 maintained potency.

Satisfactory urinary control and sexual potency could be achieved in radical cystectomy with sparing partial prostate. Further study is needed about the long-term effects of sparing prostate in cystectomy on tumor control.