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Transprostatic selective cystectomy with an ileal bladder.

A Schilling1, A Friesen

  • 1Department of Urology, Städtisches Krankenhaus Bogenhausen, Munich, FRG.

European Urology
|January 1, 1990
PubMed
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This study modified radical cystectomy (RC) and ileal neobladder surgery to preserve erectile function and urinary continence. Preliminary results in 27 patients show excellent functional outcomes, particularly reliable continence after 3 months.

Area of Science:

  • Urology
  • Surgical Oncology

Background:

  • Radical cystectomy (RC) with ileal neobladder reconstruction is a standard treatment for bladder cancer.
  • Maintaining post-operative erectile function and urinary continence are significant challenges for patients undergoing RC.

Purpose of the Study:

  • To evaluate a modified surgical approach to radical cystectomy and ileal neobladder reconstruction.
  • To assess the impact of the modified technique on preserving erectile function and urinary continence.

Main Methods:

  • A modified surgical technique involving selective cystovesiculectomy was employed.
  • The approach preserves a wider prostatic urethral tunnel for anastomosis with the ileal neobladder.
  • Routine staging transurethral resection of the prostate (TURP) was performed to detect ductal involvement.

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Main Results:

  • Preliminary results from 27 patients demonstrate excellent erectile function and urinary continence rates.
  • Continence was reliably achieved within a 3-month post-operative training period.
  • The modified technique facilitates a funnel-shaped anastomosis, potentially improving functional outcomes.

Conclusions:

  • The modified surgical approach to radical cystectomy and ileal neobladder shows promising results in preserving erectile function and urinary continence.
  • Further long-term follow-up is necessary to ascertain the oncological safety, specifically the urethral tumor recurrence rate, of this technique.