Radical cystectomy with preservation of sexual function and urinary continence: description of a new technique
OBJECTIVE: To describe the original cystoprostatectomy technique which allows the preservation of sexual and urinary function in the majority of treated patients. SURGICAL TECHNIQUE: The described technique presents some details that distinguish it from classic cystectomy: 1) a more efficient control of prostate venous and arterial tributaries; 2) preservation of prostatic capsule and enucleation of prostatic parenchyma, which is removed in block together with the bladder, without violating the vesical neck; 3) no manipulation of the distal urethral sphincteric complex; 4) preservation of seminal vesicles and maintenance of cavernous neurovascular bundles; 5) wide anastomosis between the ileal neobladder and the prostatic capsule. COMMENTS: The proposed maneuvers allow the performance of radical cystectomy with integral preservation of distal urethral sphincter and of cavernous neurovascular bundles, without jeopardizing the oncological principles.
Main Authors: | , , , , |
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Format: | Digital revista |
Language: | English |
Published: |
Sociedade Brasileira de Urologia
2003
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Online Access: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382003000400010 |
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Summary: | OBJECTIVE: To describe the original cystoprostatectomy technique which allows the preservation of sexual and urinary function in the majority of treated patients. SURGICAL TECHNIQUE: The described technique presents some details that distinguish it from classic cystectomy: 1) a more efficient control of prostate venous and arterial tributaries; 2) preservation of prostatic capsule and enucleation of prostatic parenchyma, which is removed in block together with the bladder, without violating the vesical neck; 3) no manipulation of the distal urethral sphincteric complex; 4) preservation of seminal vesicles and maintenance of cavernous neurovascular bundles; 5) wide anastomosis between the ileal neobladder and the prostatic capsule. COMMENTS: The proposed maneuvers allow the performance of radical cystectomy with integral preservation of distal urethral sphincter and of cavernous neurovascular bundles, without jeopardizing the oncological principles. |
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