title: Preservation of the internal genital organs during radical cystectomy in selected women with bladder cancer: a report on 15 cases with long term follow-up.
abstract: OBJECTIVE
  To prospectively present the technique, functional and oncological outcome of internal genitalia sparing cystectomy for bladder cancer in 15 selected women.
  
  
  METHODS
  Between January 1995 and December 2010, 305 women underwent orthotopic neobladder after radical cystectomy. Of these, 15 cases with a mean age of 42 years underwent genitalia sparing. Inclusion criteria included stage (T2b N0 Mo or less, as assessed preoperatively, unifocal tumors away from the trigone, sexually active young women and internal genitalia free of tumor. Cystectomy with preservation of the uterus, vagina and ovaries and Hautmann neobladder were performed. Oncological, functional, urodynamic and sexual outcome using Female Sexual Function Index (FSFI) were evaluated.
  
  
  RESULTS
  Definitive histopathology showed advanced stage not recognized preoperatively in 2 patients, who developed local recurrence and bony metastasis after 3-4 months. A third patient developed bony metastasis after 15 months. No recurrence developed in the retained genital organs. The remaining 12 patients remained free of disease with a mean follow-up of 70 months. Among women eligible for functional evaluation, daytime and nighttime continence were achieved in 13/13 (100%) and 12/13 (92)%, respectively. Chronic urinary retention was not noted. The urodynamic parameters were comparable to those in other patients without genital preservation. Sexual function (FSFI) was better in these patients than in others without genital preservation.
  
  
  CONCLUSIONS
  Genital sparing cystectomy for bladder cancer is feasible in selected women. It provides a good functional outcome, better sexual function and the potential for fertility preservation. So far, the oncological outcome is favorable.
authors: Urology Department, Urology and Nephrology Center, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt. balieldein@yahoo.com
authors: B
authors: B
authors: Ali-El-Dein
authors: A
authors: A
authors: Mosbah
authors: Y
authors: Y
authors: Osman
authors: N
authors: N
authors: El-Tabey
authors: M
authors: M
authors: Abdel-Latif
authors: I
authors: I
authors: Eraky
authors: A A
authors: AA
authors: Shaaban
mesh_terms: D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000379:methods*; D005260:Female; D059247:Fertility Preservation; D005836:Genitalia, Female; D006801:Humans; D008875:Middle Aged; D059351:Organ Sparing Treatments; D019529:Sexuality; D016019:Survival Analysis; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000637:transplantation*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014563:Urodynamics