[Recent progress in surgical management for urogenital cancers--improvement of patients' QOL following surgery].
We report our experience of urinary reconstruction with ileal neobladder, and nerves-paring radical cystoprostatectomy or radical prostatectomy in an attempt to improve quality of life (QOL) in patients following surgery. While the ileal neobladder is not always indicated for patients who require cystectomy for invasive bladder carcinoma, voiding through the urethra in this urinary reconstruction contributes to improvement of post-cystectomy QOL. Daytime continence is achieved in 90% of patients. However, nighttime incontinence was found in 30%, which indicates a need for further refinement of the operative procedures or more investigations into the mechanism of continence in this condition. Recovery of erectile function following nerve-sparing radical cystoprostatectomy or prostatectomy was found in 50% of the patients who received this procedure. Subjective and objective erectile capacity before operation partly determine post-operative erectile function. Several patients whose post-operative erectile function was recovered had not had sexual intercourse after surgery. Anxiety about the disease, still inadequate penile rigidity and a non-cooperative attitude of the sexual partner were involved in the results, suggesting that more careful care and counseling before and after operation are required.
Tsukamoto
T
T
Department of Urology, Sapporo Medical University School of Medicine, Japan.
Hirose
T
T
Mikuma
N
N
Sato
Y
Y
Yokoo
A
A
Adachi
H
H
D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010410:Penile Erection; D011468:Prostatectomy / Q000379:methods*; D011788:Quality of Life; D014547:Urinary Diversion / Q000379:methods*; D014554:Urination; D014565:Urogenital Neoplasms / Q000503:physiopathology / Q000601:surgery*