Oncologische en functionele resultaten na seksualiteitsparende cystectomie en neoblaas

Translated title of the contribution: Oncological and functional results after sexuality-sparing cystectomy and neobladder

Research output: Contribution to journalArticleProfessional

Abstract

The radical cystectomy consists of excision of the bladder including prostate and seminal vesicles in men. In this procedure the autonomic nerves, which are essential for a normal sexual response and contribute to urinary continence, are often damaged. To reduce the chance of incontinence and sexual dysfunction a prostate sparing cystectomy was done, of which oncological and functional results are analysed. In 44 patients the vasa deferentia, seminal vesicles, and prostate were preserved during cystectomy, after which a neobladder was anastomosed to the outer rim of the prostate. Pre-operative evaluation consisted of PSA measurements, rectal ultrasound and sextant prostate biopsies, and TUR-sampling of the bladder neck and prostatic urethra. Erectile function and neobladder function were evaluated by structured interviews and questionnaires. After a median follow-up of 42 months, 13 patients died of widespread disease, in 3 (7%) patients this was combined with a local recurrence. Survival after 3 years was 86% for pT≤2N0, 63% for pT3N0, and 39% for lymph node positive patients (TxNpos). One patient developed prostate carcinoma, another patient developed recurrent carcinoma in situ in the prostatica urethra. Continence during day- and nighttimes was complete in 95 and 74% respectively, satisfactory (one pad) in 5 and 21%, and bad (>1 pad) in 0 and 5%. Post-void residual volume was insignificant in 72%, 21% started clean intermittent catheterisation (CIC) for post void residual volume, and 7% was completely CIC dependent. Postoperative erectile function could be determined in 40 patients; in 77.5% erectile function was complete, in 12.5% impaired, and absent in 10%. The SPCN results in good postoperative erectile function and continence, without additional oncological risks, although longer follow-up and more patients are needed to confirm the oncological results.
Translated title of the contributionOncological and functional results after sexuality-sparing cystectomy and neobladder
Original languageDutch
Pages (from-to)140-144
Number of pages5
JournalNederlands Tijdschrift voor Urologie
Volume13
Issue number6
Publication statusPublished - Oct 2005

Keywords

  • Bladder cancer
  • Cystectomy
  • Erectile function
  • Oncology
  • Prostate sparing
  • Sexuality

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