Nerve and Seminal Sparing Cystectomy for Bladder Cancer

Moon, Kyung Hyun; Park, Sungchan; Ahn, Hanjong

Abstract

PURPOSE: We report our experiences of nerve and seminal sparing cystectomy to improve of daytime and nighttime urinary continence and sexual function in patients requiring a radical cystoprostatectomy.
MATERIALS AND METHODS
Between December 1999 and December 2003, the data from 17 patients who underwent a nerve and seminal sparing cystectomy were compared with those from 18 patients who underwent a radical cystoprostatectomy for a malignant neoplasm of the bladder. No patient had erectile dysfunction or voiding problems prior to surgery. All patients had organ-confined tumors (stage Ta-2N0M0). The mean ages and follow- up periods were 54.4 years and 16.1 months for the study group and 59.4 years and 17.9 months for the control group.
RESULTS
The rates of potency, daytime continence and night-time continence were 93.8, 100 and 81.3%, respectively, in the patients who underwent nerve and seminal sparing cystectomy, and 0, 94.4 and 50%, respectively in those who underwent radical cystoprostatectomy. Within 3 days of the Foley catheter removal, 31 and 19% had daytime and nighttime continence, respectively, in those who underwent nerve and seminal sparing cystectomy.
CONCLUSIONS
In patients with considerable concern relating to sexual activity, and in those anxious about loss of urinary continence after radical cystoprostatectomy, a nerve and seminal sparing cystectomy can be used, which elevates the quality of life via preservation of physiological voiding and normal sexual function with oncological safety if patients are selected carefully.