title: Uterus, fallopian tube, ovary and vagina-sparing laparoscopic cystectomy: technical description and results.
abstract: OBJECTIVE
  The purpose of our study was to demonstrate, describe, and assess the results of the technique of laparoscopic cystectomy sparing the uterus, fallopian tubes, ovaries, and vagina.
  
  
  METHODS
  Between July 2004 and December 2005, 13 women with neurogenic vesical dysfunction (mean age: 53.3+/-13.0 yr) underwent laparoscopic cystectomy sparing the uterus, fallopian tubes, ovaries, and vagina. A noncontinent transileal Bricker diversion was performed extracorporeally in each case. Parameters studied were the pre-, peri- and postoperative data.
  
  
  RESULTS
  Mean duration of the operation was 325+/-36 min, and mean blood loss was 323.1+/-246.3 ml. No conversion was required. One perioperative complication was observed: a tear in a branch of the right hypogastric vein, which was sutured under laparoscopy. One patient was transfused during surgery (2 units of blood). No early or late postoperative complications were observed. One patient required transfusion of 2 units of red blood cell concentrate on the first day after surgery. None of the patients required opiate analgesia in the postoperative period. The analgesic regimen used was paracetamol and nefopam in all cases. The pain score on an analogic visual scale was less than 4 in all cases. Resumption of transit was not delayed in any of the patients. Mean hospital stay was 11.6+/-1.9 d. Over an average follow-up of 7.4+/-5.4 mo, none of the patients developed late complications. Before surgery, 77% of the women were sexually active; 80% of them were sexually active 4 mo after the surgery.
  
  
  CONCLUSIONS
  Laparoscopic cystectomy sparing the uterus, fallopian tubes, ovaries, and vagina is feasible. This operation has low morbidity and requires only a limited stay in hospital.
authors.affiliation: Department of Urology, Renal Transplant and Andrology, CHU Rangueil, Toulouse, France. xaviergame@hotmail.com <xaviergame@hotmail.com>
authors.forename: Xavier
authors.initials: X
authors.lastname: Gamé
authors.forename: Richard
authors.initials: R
authors.lastname: Mallet
authors.forename: Julien
authors.initials: J
authors.lastname: Guillotreau
authors.forename: Nathalie
authors.initials: N
authors.lastname: Berrogain
authors.forename: Marc
authors.initials: M
authors.lastname: Mouzin
authors.forename: Christophe
authors.initials: C
authors.lastname: Vaessen
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Sarramon
authors.forename: Bernard
authors.initials: B
authors.lastname: Malavaud
authors.forename: Pascal
authors.initials: P
authors.lastname: Rischmann
mesh_terms: D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000379:methods*; D005187:Fallopian Tubes; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010053:Ovary; D001750:Urinary Bladder, Neurogenic / Q000601:surgery*; D014599:Uterus; D014621:Vagina