title: Cystoprostatectomy and substitution cystoplasty for locally invasive bladder cancer.
abstract: The results and long-term follow-up of 48 patients undergoing cystoprostatectomy and substitution cystoplasty for T2/3, M0 transitional cell carcinoma of the bladder are reported. There was no operative mortality but 1 early death from thromboembolic disease. Thirty-six patients are alive with a mean follow-up of 57 months (range 12-120). Eleven patients died of disseminated disease. Thirty-one patients (64%) regained normal continence by day and night and a further 8 were dry by day but incontinent at night; 9 patients underwent further surgery for incontinence and this was successful in 8, giving an overall continence rate of 79% and a day-time continence rate of 98%. Of the 38 patients claiming to be potent pre-operatively, 24 (63%) were potent post-operatively. Nerve-sparing cystoprostatectomy and substitution cystoplasty is a safe alternative to a "standard" cystectomy and ileal conduit diversion in a selected group of men undergoing radical surgery for invasive bladder cancer and it achieves its aims of preserving continence and potency in the majority of patients.
authors.affiliation: Department of Urology, Guy's Hospital, London.
authors.forename: P J
authors.initials: PJ
authors.lastname: Thomas
authors.forename: D E
authors.initials: DE
authors.lastname: Nurse
authors.forename: C
authors.initials: C
authors.lastname: Deliveliotis
authors.forename: A R
authors.initials: AR
authors.lastname: Mundy
mesh_terms: D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000401:mortality / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D007172:Erectile Dysfunction / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011468:Prostatectomy / Q000379:methods*; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology