Sexuality preserving cystectomy and neobladder (SPCN): functional results of a neobladder anastomosed to the prostate.
OBJECTIVE
In order to preserve the sexual functions in patients in need of a cystectomy, a feasibility study has been performed.


METHODS
In 24 male patients the seminal vesicles and the prostate were left in situ and a Studer type neobladder was anastomosed to the lateral edge of the prostate.


RESULTS
Storage and voiding strongly resembled the patterns reported in neobladder patients with the anastomosis directly to the urethra. Four of the 24 males needed to perform clean intermittent catheterisation (CIC). All but one patients had daytime continence. Three patients needed a pad at night. Five patients had erectile dysfunction, of whom two responded well to sildenafil treatment, one had good rigiscan measured nightly erectile function and one had poor erections prior to the operation. Half of the patients had antegrade ejaculation, two patients reported sometimes antegrade and sometimes retrograde ejaculation.


CONCLUSIONS
This feasibility trial showed that in the majority of our patients the remaining prostate does not interfere with micturition and the sexual functions were preserved.
Meinhardt
W
W
Department of Urology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. w.meinhardt@nki.nl
Horenblas
S
S
D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000379:methods*; D007172:Erectile Dysfunction / Q000209:etiology; D005240:Feasibility Studies; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011183:Postoperative Complications; D011467:Prostate / Q000503:physiopathology / Q000601:surgery; D019529:Sexuality; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery*; D014547:Urinary Diversion; D014549:Urinary Incontinence / Q000209:etiology; D016476:Urinary Reservoirs, Continent; D014563:Urodynamics