R Colombo1, F Pellucchi2, M Moschini3, A Gallina1, R Bertini1, A Salonia1, P Rigatti1, F Montorsi1. 1. Departments of Urology, Urological Research Institute, Vita-Salute San Raffaele University, San Raffaele Hospital, San Raffaele Scientific Institute, Via Olgettina, 60-20132, Milan, Italy. 2. Department of Urology, Papa Giovanni XXIII Hospital, Bergamo, Italy. 3. Departments of Urology, Urological Research Institute, Vita-Salute San Raffaele University, San Raffaele Hospital, San Raffaele Scientific Institute, Via Olgettina, 60-20132, Milan, Italy. marco.moschini87@gmail.com.
Abstract
OBJECTIVES: To evaluate technical feasibility and oncologic and functional outcomes of three different surgical procedures of nerve-sparing radical cystectomy (NS-RC) for the treatment of organ-confined bladder cancer at a single referral centre. MATERIALS AND METHODS: All consecutive cases of NS-RC carried out between 1997 and 2012 were retrospectively analysed. NS-RC included nerve-sparing cysto-vesicleprostatectomy (NS-CVP), capsule-sparing cystectomy (CS-C) and seminal-sparing cysto-prostatectomy (SS-CP). Peri-operative parameters and post-operative outcomes were analysed. RESULTS: Overall, 90 patients underwent NS-RC, 35 (38.9 %) of whom received a NS-CVP, while 36 (40 %) and 19 (21.1 %) underwent capsule CS-C and SS-CP, respectively. No difference was registered comparing oncologic outcomes of the three different techniques; however, two local recurrences after CS-C were attributed to the surgical technique. Complete post-operative daytime and night-time urinary continence (UC) at 24 and 48 months was achieved in 94.4 and 74.4 % and in 88.8 and 84.4 % of cases, respectively. CS-C showed both the best UC and sexual function preservation rate at early follow-up (24 months). Overall, a satisfactory post-operative erectile function (IIEF-5 ≥ 22) was proved in 57 (68.6 %) and 54 (65.0 %) patients at 24 and 48 months, respectively. Significant difference was found when comparing sexual function preservation rate of NS-CVP (28.5 %) to that of CS-C (91.6 %) and SS-CP (84.2 %). CONCLUSION: NS-RC for male patients accounted for 7.4 % of overall radical cystectomy. To a limited extent of the selected organ-confined bladder cancers treated, the three different procedures analysed showed comparable results in terms of local recurrence and cancer-specific survival. Both CS-C and SS-CP procedures provided excellent functional outcomes when compared to original NS-CVP.
OBJECTIVES: To evaluate technical feasibility and oncologic and functional outcomes of three different surgical procedures of nerve-sparing radical cystectomy (NS-RC) for the treatment of organ-confined bladder cancer at a single referral centre. MATERIALS AND METHODS: All consecutive cases of NS-RC carried out between 1997 and 2012 were retrospectively analysed. NS-RC included nerve-sparing cysto-vesicleprostatectomy (NS-CVP), capsule-sparing cystectomy (CS-C) and seminal-sparing cysto-prostatectomy (SS-CP). Peri-operative parameters and post-operative outcomes were analysed. RESULTS: Overall, 90 patients underwent NS-RC, 35 (38.9 %) of whom received a NS-CVP, while 36 (40 %) and 19 (21.1 %) underwent capsule CS-C and SS-CP, respectively. No difference was registered comparing oncologic outcomes of the three different techniques; however, two local recurrences after CS-C were attributed to the surgical technique. Complete post-operative daytime and night-time urinary continence (UC) at 24 and 48 months was achieved in 94.4 and 74.4 % and in 88.8 and 84.4 % of cases, respectively. CS-C showed both the best UC and sexual function preservation rate at early follow-up (24 months). Overall, a satisfactory post-operative erectile function (IIEF-5 ≥ 22) was proved in 57 (68.6 %) and 54 (65.0 %) patients at 24 and 48 months, respectively. Significant difference was found when comparing sexual function preservation rate of NS-CVP (28.5 %) to that of CS-C (91.6 %) and SS-CP (84.2 %). CONCLUSION: NS-RC for male patients accounted for 7.4 % of overall radical cystectomy. To a limited extent of the selected organ-confined bladder cancers treated, the three different procedures analysed showed comparable results in terms of local recurrence and cancer-specific survival. Both CS-C and SS-CP procedures provided excellent functional outcomes when compared to original NS-CVP.
Authors: Laura S Mertens; Richard P Meijer; Remco R de Vries; Jakko A Nieuwenhuijzen; Henk G van der Poel; Axel Bex; Bas W G van Rhijn; Wim Meinhardt; Simon Horenblas Journal: J Urol Date: 2013-11-25 Impact factor: 7.450
Authors: Remco R de Vries; Jakko A Nieuwenhuijzen; Harm van Tinteren; Jorg R Oddens; Otto Visser; Henk G van der Poel; Axel Bex; Willem Meinhardt; Simon Horenblas Journal: BJU Int Date: 2009-06-22 Impact factor: 5.588
Authors: Atiqullah Aziz; Michael Gierth; Michael Rink; Marianne Schmid; Felix K Chun; Roland Dahlem; Florian Roghmann; Rein-Jüri Palisaar; Joachim Noldus; Jörg Ellinger; Stefan C Müller; Armin Pycha; Thomas Martini; Christian Bolenz; Rudolf Moritz; Edwin Herrmann; Bastian Keck; Bernd Wullich; Roman Mayr; Hans-Martin Fritsche; Maximilian Burger; Patrick J Bastian; Christian Seitz; Sabine Brookman-May; Evanguelos Xylinas; Shahrokh F Shariat; Margit Fisch; Matthias May Journal: World J Urol Date: 2015-05-07 Impact factor: 4.226
Authors: Marco Moschini; Francesco Soria; Martin Susani; Stephan Korn; Alberto Briganti; Morgan Roupret; Christian Seitz; Killian Gust; Andrea Haitel; Francesco Montorsi; Gregory Wirth; Brian D Robinson; Pierre I Karakiewicz; Mehmet Özsoy; Michael Rink; Shahrokh F Shariat Journal: Bladder Cancer Date: 2017-07-27