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首页> 外文期刊>Urologic oncology >Prostate-sparing cystectomy: a review of the oncologic and functional outcomes. Contraindicated in patients with bladder cancer.
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Prostate-sparing cystectomy: a review of the oncologic and functional outcomes. Contraindicated in patients with bladder cancer.

机译：前列腺保留膀胱切除术：肿瘤和功能结局的审查。禁忌于膀胱癌患者。

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PURPOSE: The standard treatment of high-grade, invasive bladder cancer is radical cystectomy. Prostate-sparing techniques have recently become an alternative surgical approach for the treatment of the disease. We review the literature regarding the oncologic and functional outcomes for prostate-sparing approaches. MATERIALS AND METHODS: The literature pertaining to prostate-sparing cystectomy was reviewed. The oncologic issues of preserving the prostate in patients undergoing cystectomy for bladder cancer along with the functional outcomes were evaluated. RESULTS: There is a significant incidence of bladder and prostate cancer involving the prostate, and prostate apex in men requiring cystectomy for transitional cell carcinoma of the bladder at the time of surgery. This involvement of the prostate with cancer maybe difficult to determine preoperatively. Importantly, although prostate-sparing procedures provide good potency results, the functional outcomes following cystectomy and orthotopic diversion to the urethra are not significantly different, particularly regarding daytime continence. Lastly, several studies suggest the oncologic outcomes following prostate-sparing cystectomy may be compromised with this surgical approach. CONCLUSIONS: The significant incidence of bladder and prostate cancer involving the prostate at the time of cystectomy, which is difficult to determine preoperatively, may preclude the general application of prostate-sparing techniques in most men requiring cystectomy. Concerns regarding the oncologic outcomes with prostate-sparing techniques, coupled with the excellent results seen with traditional radical cystectomy and orthotopic diversion, suggest that prostate-sparing procedure should be performed only in well-selected individuals.
机译：目的：高级浸润性膀胱癌的标准治疗是根治性膀胱切除术。前列腺保留技术最近已成为治疗该疾病的另一种外科手术方法。我们回顾了有关前列腺保留方法的肿瘤学和功能结局的文献。材料与方法：回顾了有关前列腺保留膀胱切除术的文献。评估了膀胱癌膀胱切除术患者保留前列腺的肿瘤学问题以及功能结局。结果：在需要膀胱切除术治疗膀胱移行细胞癌的男性中，涉及前列腺和前列腺尖的膀胱癌和前列腺癌发生率很高。前列腺癌的累及可能很难在术前确定。重要的是，尽管保留前列腺的程序可提供良好的效价结果，但膀胱切除术和原位转移至尿道后的功能结局并没有显着差异，特别是在日间失禁方面。最后，一些研究表明，保留前列腺的膀胱切除术后的肿瘤学结局可能会受到这种手术方法的损害。结论：膀胱切除术时涉及前列腺的膀胱癌和前列腺癌的高发率很难在术前确定，这可能排除了前列腺保留技术在大多数需要进行膀胱切除术的男性中的普遍应用。有关前列腺保留技术的肿瘤学结局的担忧，再加上传统的根治性膀胱切除术和原位转移术所见的优异结果，提示前列腺保留手术仅应在经过精心挑选的个体中进行。

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