Sparing radical cystectomy - How much is enough?

Radical cystectomy in females is increasingly being followed by orthotopic urinary diversion. This is particularly true when it comes to young patients. Wisahi et al. [1] from Egypt describe a small series of such patients with Bilharziosis associated bladder cancer. The results presented match well with those presented in other series [2, 3, 4]. Nerve-sparing radical cystectomy has been shown to be the most important determinant for subsequent neobladder function and sexual quality of life. Preservation of the uterus as proposed herein allows for very extensive nerve sparing. Moreover, dorsal stability is provided for the neobladder, which is also considered helpful in preventing obstruction. However, even with this approach still 3 women require CIC in this group. One may argue that other unknown factors could also be influential. Neobladder type itself does not Sparing radical cystectomy – How much is enough?