Marco Castagnetti1, Lorenzo Angelini2, Rita Alaggio3, Giovanni Scarzello4, Gianni Bisogno5, Waifro Rigamonti2. 1. Section of Pediatric Urology, Urology Unit, University Hospital of Padova, Padua, Italy. Electronic address: marcocastagnetti@hotmail.com. 2. Section of Pediatric Urology, Urology Unit, University Hospital of Padova, Padua, Italy. 3. Pathology Department, University Hospital of Padova, Padua, Italy. 4. Radiotherapy Division, Istituto Oncologico Veneto, Padua, Italy. 5. Hematology/Oncology Division, Woman's and Child's Health Department, University Hospital of Padova, Padua, Italy.
Abstract
PURPOSE: We determined the oncologic and urological outcomes in patients with bladder/prostate rhabdomyosarcoma according to the type and timing of urinary tract surgery, with emphasis on the role of the Padua orthotopic ileal neobladder. MATERIALS AND METHODS: We retrospectively analyzed oncologic and urological outcomes of 11 consecutive patients treated at our institution between 1998 and 2012. RESULTS: Two patients underwent urethrectomy and placement of a heterotopic catheterizable ileal neobladder. The membranous urethra was preserved in 9 patients, 6 underwent primary Padua ileal neobladder at radical cystectomy, 2 underwent delayed Padua ileal neobladder and 1 underwent bilateral cutaneous ureterostomy. Four of these 9 patients experienced disease recurrence, including local recurrence in 2 despite negative intraoperative biopsies. Survivors undergoing heterotopic catheterizable ileal neobladder or primary Padua ileal neobladder learned to empty the bladder to completion without long-term upper tract deterioration. Both cases managed by delayed Padua ileal neobladder required clean intermittent catheterization eventually. Erections were reported in 5 of 6 surviving males. CONCLUSIONS: The Padua ileal neobladder allowed preservation of volitional urethral voiding in all survivors in whom it was placed at radical cystectomy. Nevertheless, local recurrence was noted in 2 of the 9 cases where the membranous urethra was preserved. By comparison, patients undergoing delayed Padua ileal neobladder after attaining disease-free status never achieved voiding per urethra. Therefore, a heterotopic reservoir might be a more reliable choice under these circumstances. Erectile function is preserved in the majority of cases.
PURPOSE: We determined the oncologic and urological outcomes in patients with bladder/prostate rhabdomyosarcoma according to the type and timing of urinary tract surgery, with emphasis on the role of the Padua orthotopic ileal neobladder. MATERIALS AND METHODS: We retrospectively analyzed oncologic and urological outcomes of 11 consecutive patients treated at our institution between 1998 and 2012. RESULTS: Two patients underwent urethrectomy and placement of a heterotopic catheterizable ileal neobladder. The membranous urethra was preserved in 9 patients, 6 underwent primary Padua ileal neobladder at radical cystectomy, 2 underwent delayed Padua ileal neobladder and 1 underwent bilateral cutaneous ureterostomy. Four of these 9 patients experienced disease recurrence, including local recurrence in 2 despite negative intraoperative biopsies. Survivors undergoing heterotopic catheterizable ileal neobladder or primary Padua ileal neobladder learned to empty the bladder to completion without long-term upper tract deterioration. Both cases managed by delayed Padua ileal neobladder required clean intermittent catheterization eventually. Erections were reported in 5 of 6 surviving males. CONCLUSIONS: The Padua ileal neobladder allowed preservation of volitional urethral voiding in all survivors in whom it was placed at radical cystectomy. Nevertheless, local recurrence was noted in 2 of the 9 cases where the membranous urethra was preserved. By comparison, patients undergoing delayed Padua ileal neobladder after attaining disease-free status never achieved voiding per urethra. Therefore, a heterotopic reservoir might be a more reliable choice under these circumstances. Erectile function is preserved in the majority of cases.
Authors: Joshua Lara; Ann Brunson; Theresa H M Keegan; Marcio Malogolowkin; Chong-Xian Pan; Stanley Yap; Ralph deVere White Journal: J Urol Date: 2016-05-18 Impact factor: 7.450
Authors: Timothy B Lautz; Yueh-Yun Chi; Minjie Li; Suzanne L Wolden; Dana L Casey; Jonathan C Routh; Candace F Granberg; Odion Binite; Erin R Rudzinski; Douglas S Hawkins; Rajkumar Venkatramani; David A Rodeberg Journal: Cancer Date: 2020-10-20 Impact factor: 6.921