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Updated: Feb 11, 2026
11:29
Surgical Techniques to Optimize Ovarian Reserve during Laparoscopic Cystectomy for Ovarian Endometrioma
Published on: January 22, 2022
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[Radical cystectomy and urinary diversion-what is important ?]
J Noldus1, G Niegisch2, A Pycha3,4
1Urologische Universitätsklinik, Marien Hospital Herne, Ruhr-Universität Bochum, Herne, Deutschland.
Der Urologe. Ausg. A
|April 27, 2018
Summary
Optimizing pre-, peri-, and postoperative care for radical cystectomy with urinary diversion improves patient outcomes. Enhanced Recovery after Surgery (ERAS) protocols and managing comorbidities are key for successful treatment of muscle invasive urothelial bladder cancer.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Radical cystectomy with urinary diversion is the standard treatment for localized muscle invasive urothelial bladder cancer in Germany.
- Pre-, peri-, and postoperative management modifications have significantly improved patient outcomes.
Purpose of the Study:
- To provide an overview of the optimal approach for radical cystectomy and urinary diversion.
- To discuss factors influencing patient outcomes.
Main Methods:
- Analysis of preparation and procedural data for radical cystectomy and urinary diversion.
- Review of preoperative, perioperative, and postoperative management strategies.
Main Results:
- Preoperative: Implement Fast Track and Enhanced Recovery after Surgery (ERAS) concepts; manage comorbidities (diabetes, hypertension, malnutrition, anemia).
- Perioperative: Optimize fluid management, anesthesiologist collaboration, controlled hypotension, minimize blood products, and utilize epidural anesthesia for pain management and recovery.
- Surgical: Radical cystectomy offers the best oncological outcomes; nerve-sparing techniques and robotic-assisted radical cystectomy (RARC) should be considered for quality of life.
Conclusions:
- The ileum conduit remains the most common urinary diversion globally.
- Various urinary diversion options exist to maximize patient quality of life.
- High-volume centers are associated with improved patient outcomes.
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