Inflatable penile prostheses in patients undergoing cystoprostatectomy with urethrectomy

Area of Science:

• Urology
• Oncology
• Reconstructive Surgery

Background:

• Cystoprostatectomy with urethrectomy presents challenges in penile reconstruction and sexual rehabilitation for male patients with transitional cell carcinoma.
• The management of the urethra during radical cystectomy impacts outcomes for patients requiring penile prosthesis implantation.

Purpose of the Study:

• To evaluate the efficacy and outcomes of inflatable penile prostheses in patients undergoing cystoprostatectomy with urethrectomy.
• To compare results based on the preservation or total removal of the glandular urethra.

Main Methods:

• Retrospective analysis of 19 male patients who received inflatable penile prostheses after cystoprostatectomy with urethrectomy.
• Patients were divided into two groups: en bloc urethrectomy with delayed prosthesis placement (13 patients) and simultaneous prosthesis implantation (6 patients).
• Outcomes assessed included healing, prosthesis function, and patient satisfaction, with specific attention to urethral preservation.

Main Results:

• All 19 patients achieved appropriate healing and adequate prosthesis function.
• Patients who could safely preserve the glandular urethra demonstrated significantly superior results compared to those with total urethrectomy.
• Preservation of the glandular urethra facilitated easier prosthesis placement, improved glans support, enhanced sensation, and better aesthetic outcomes.

Conclusions:

• Inflatable penile prostheses are a viable and successful option for sexual rehabilitation in patients undergoing cystoprostatectomy with urethrectomy.
• Preserving the glandular urethra during surgery is crucial for optimizing functional and aesthetic outcomes following penile prosthesis implantation.
• The study highlights the importance of surgical technique in maximizing patient satisfaction after radical cystectomy and urethrectomy.