Laparoscopic radical cystectomy with prostate capsule sparing. Initial experience.
BACKGROUND
In 2008, our department introduced a modified technique of laparoscopic radical cystectomy in which the prostatic capsule is spared in selected patients with bladder cancer. The different series published are mostly using the standard open procedure. The aim of this study is to describe this technique using the laparoscopic approach and present our preliminary results.


METHODS
This study includes 20 patients selected by clinical analysis and imaging criteria operated using laparoscopic radical cystectomy with prostate capsule sparing at our department in the period between 2008 and 2012.


RESULTS
Patient mean age was 58 years. Mean operative time was 390 minutes. Median follow-up was 36 months. No patient had bladder cancer recurrence. Only one patient died of disease progression, as the pathological findings was a pT3 pN1 Mx. Mean PSA before surgery: 1.3 ng/ml (03-2), mean PSA after surgery 1.0 ng/ml (0.08-1.7). No patients had prostate cancer recurrence. Satisfactory daytime and night-time continence was achieved. 90% of patients have sexual function preserved.


CONCLUSIONS
Prostate-sparing radical cystectomy remains one of the most controversial topics in urology today. The laparoscopic approach could be an alternative to conventional radical cystoprostatectomy in well selected patients, done in experienced institutions in order to find better functional results, with a low disease progression and recurrence rate.
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Juan Gómez
JG
Rivas
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Sergio Alonso Y
SA
Gregorio
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Ángel Tabernero
ÁT
Gómez
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Mario
M
Alvarez-Maestro
Department of Biostatistics, Hospital Universitario La Paz, Madrid, Spain.
Jesús Díez
JD
Sebastián
Department of Urology, Hospital Universitario La Paz, Madrid, Spain.
Jesús Cisneros
JC
Ledo
cystectomy; laparoscopic; prostate capsule sparing