Cystectomy Sparing the Prostate and Seminal Vesicles

Abstract

Aim — improving the results of cystectomy by retaining the prostate and seminal vesicles.
87 cystectomies with restoration of urination and sparing the prostate with or without seminal vesicles were carried out in patients with vesical cancer in 1991—2005. Patients' ages varied from 33 to 75 years (mean age 56.1 years). The following modifications were performed: transprostatic cystovesiculectomy (11 pts), transprostatic and supraprostatic cystectomy (53 and 23 pts, respectively). The absence of prostatic cancer and negative data of urgent histological study of the resection margin were indications for reducing the standard volume of surgery.
Postoperative mortality was 2.3%. Mean period of observation was 60.8 months. Local relapses were diagnosed in 2.5%, remote metastases in 12.9% patients. Day-time continence was attained in 100%, nocturnal in 96.4% patients. Erectile function was retained in 79.6% patients. Cystectomy within normal tissues sparing the prostate and seminal vesicles helps preserve the optimally possible preoperative functional status without deteriorating oncological results.