Functional and Oncological Outcomes of Female Pelvic Organ-preserving Robot-assisted Radical Cystectomy
| Autor: | Etienne Lavallée, Zach Dovey, Prachee Pathak, Linda Dey, Lotta Renström Koskela, Arad Hosseini, Nikhil Waingankar, Reza Mehrazin, John Sfakianos, Abolfazl Hosseini, Peter Wiklund |
|---|---|
| Rok vydání: | 2021 |
| Předmět: | |
| Zdroj: | European Urology Open Science European Urology Open Science, Vol 36, Iss, Pp 34-40 (2022) |
| ISSN: | 2666-1683 |
| Popis: | Take Home Message Pelvic organ-preserving robot-assisted radical cystectomy with orthotopic neobladder or ileal conduit allows return to sexual activity after surgery while not compromising oncological outcome. This approach should be considered in sexually active female undergoing cystectomy. Background For females undergoing cystectomy and urinary diversion, decreases in sexual and urinary functions can have a significant impact on quality of life. Pelvic organ–preserving (POP) radical cystectomy (RC) has been proposed as an approach to improve postoperative functional outcomes. Objective To evaluate postoperative functional outcomes of a robotic approach for female POP RC with intracorporeal urinary diversion. Design, setting, and participants This was a multicenter retrospective study evaluating sexual, urinary, and oncological outcomes for sexually active females undergoing POP robot-assisted RC for ≤T2 bladder cancer. Exclusion criteria included multifocal, trigonal, or locally advanced tumors. Surgical procedure We describe a step-by-step technique for POP robot-assisted RC with intracorporeal urinary diversion. Measurements The primary outcome of the study was evaluation of sexual and urinary functions following surgery. Oncological outcomes were evaluated as a secondary endpoint. Results and limitations Our study included 23 females who underwent POP robot-assisted RC between 2008 and 2020 with intracorporeal neobladder (87%) or ileal conduit (13%) reconstruction. The median follow-up was 20 mo. A postoperative sexual function questionnaire was completed by 15 patients (65%). Of those, 13 (87%) resumed sexual activity at a median of 6 mo after surgery. Of the patients with a neobladder, 14 (70%) achieved daytime continence and 16 (80%) achieved nighttime continence. Cancer-specific and overall survival were both 91%. The results are limited by their retrospective nature. Conclusions POP robot-assisted RC with orthotopic neobladder allows a majority of female patients to return to sexual activity after surgery. This approach should be considered for selected sexually active women. Patient summary We evaluated 23 women with bladder cancer who underwent surgical removal of the bladder with preservation of their reproductive organs. Following this surgery, a majority of patients resumed sexual activity. For selected patients, this technique can be performed without compromising cancer control. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|