Perineal-abdominal cystourethrectomy with pelvic node dissection: a new 2-stage procedure for selected cases

Area of Science:

• Urology
• Surgical Oncology

Background:

• Bladder cancer presents significant treatment challenges, particularly in advanced stages.
• Complex pelvic anatomy due to prior surgeries can complicate radical cystectomy.

Purpose of the Study:

• To describe a two-stage surgical technique for bladder carcinoma.
• To evaluate the feasibility of cystourethrectomy with pelvic node dissection in specific patient cohorts.

Main Methods:

• A cohort of 20 patients with bladder carcinoma underwent ileal conduit diversion followed by cystourethrectomy with pelvic node dissection.
• The procedure involved a perineal dissection followed by abdominal completion via a Pfannenstiel incision.

Main Results:

• The study focused on patients with advanced bladder cancer involving the bladder neck, prostatic urethra, or prostate.
• Patients with prior pelvic surgery and dense adhesions were also included.

Conclusions:

• This two-stage surgical approach is a viable option for select patients with advanced bladder carcinoma.
• The technique addresses challenges posed by locally advanced disease and complex pelvic conditions.