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Chinese Journal of Endourology(Electronic Edition) ›› 2023, Vol. 17 ›› Issue (01): 16-21. doi: 10.3877/cma.j.issn.1674-3253.2023.01.004

• Clinical Research • Previous Articles     Next Articles

Urinary continence and erectile function of laparoscopic radical cystectomy with prostatic apical capsule sparing and W-shaped ileal neobladder

Sheng Xue1,(), Qingwen Li1, Jianmin Liu1, Sheng Wang1, Chengyong Wang1, Beibei Liu1, Wenyong Li1, Xiaole Zhang1, Changyuan Dai1   

  1. 1. Department of Urology, The First Affiliated Hospital of Bengbu Medical College, Anhui 233000, China
  • Received:2022-08-29 Online:2023-02-01 Published:2022-12-12
  • Contact: Sheng Xue

Abstract:

Objective

To investigate the clinical effect of laparoscopic radical cystectomy with prostatic apical capsule sparing and W-shaped orthotopic ileal neobladder.

Methods

Clinical data of 43 patients underwent laparoscopic radical cystectomy with W-shaped ileum orthotopic neobladder from January 2019 to December 2021 were collected. 20 cases were in prostatic apical capsule sparing group (observation group) and 23 cases were in the non prostatic apical capsule sparing group (control group). In the observation group, the prostatic apical capsule was cut at 1.0 cm from the tip of the prostate, the prostate was enucleated, and part of the prostatic apical capsule was reserved for laparoscopic radical cystectomy. The control group underwent conventional laparoscopic radical cystectomy. W-shaped ileal neobladder reconstructions were the same in both groups. The catheters were removed 3 weeks after operation, and the patients were reviewed regularly every 3 months. The clinical data and complete follow-up information of all patients were collected.

Results

All operation were finished successfully. Follow-up of all patients for 6-40 months revealed no tumor recurrence. There were no significant differences between two groups in preoperative demographic data, bladder tumor stage, operation time, intraoperative bleeding, intraoperative complications, 90-day postoperative complication rate and neobladder residual urine volume 6 months after operation (P>0.05). Six months after operation, the urinary function and erectile function (IIEF-5 score) of the observation group were better than that of the control group. Daytime continence were 85.0% and 52.2% respectively (P<0.05), nighetime continence were 65.0% and 34.8% respectively (P<0.05), and the IIEF-5 score were [8(6, 9)] and [3(2, 5)] respectively (P<0.05).

Conclusion

Laparoscopic radical cystectomy with prostatic apical capsule sparing and W-shaped orthotopic ileal neobladder is conducive to urinary continence and erectile function which would not increase the risk of tumor recurrence. So it is worthy of clinical application.

Key words: Bladder cancer, Ileal neobladder, Prostate-capsule sparing

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