V09-06 PROSTATE-CAPSULE SPARING RADICAL CYSTECTOMY WITH MODIFIED W-POUCH ORTHOTOPIC NEOBLADDER RECONSTRUCTION

Abstract

You have accessJournal of UrologyCME1 May 2022V09-06 PROSTATE-CAPSULE SPARING RADICAL CYSTECTOMY WITH MODIFIED W-POUCH ORTHOTOPIC NEOBLADDER RECONSTRUCTION Christopher Dall, Charlotte Goldman, James Mason, Lisa Chuong, Keith Kowalczyk, Lambros Stamatakis, and Ross Krasnow Christopher DallChristopher Dall More articles by this author , Charlotte GoldmanCharlotte Goldman More articles by this author , James MasonJames Mason More articles by this author , Lisa ChuongLisa Chuong More articles by this author , Keith KowalczykKeith Kowalczyk More articles by this author , Lambros StamatakisLambros Stamatakis More articles by this author , and Ross KrasnowRoss Krasnow More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002617.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: For patients who undergo radical cystectomy (RC) with orthotopic neobladder, erectile dysfunction and urinary symptoms may have a large impact in quality of life. This video demonstrates our prostate-capsule sparing radical cystectomy (PSC-RC) surgical technique, which may improve these functional outcomes in appropriately selected patients. METHODS: In this video demonstration, we describe development of the posterior plane and dissection anterior to the seminal vesicles and vas deferens. The Space of Retzius is entered and the bladder mobilized anteriorly. The prostatic capsule is incised at the 11 o’clock and 1 o’clock positions and the prostate adenoma enucleated. The urethra is transected distally to the prostate adenoma. A modified W-pouch orthotopic neobladder is then created using 30 cm of dependent terminal ileum approximately 25-30cm proximal to the ileocecal valve. The ileum is first detubularized, followed by sewing of the posterior plate. The urethroenteric anastomosis is performed, following by closure of the anterior plate of the neobladder. The ureteroenteric anastomoses are then completed using the proximal and distal end of the neobladder pouch. RESULTS: Data presented in several papers indicates high levels of both daytime and nighttime continence. Satisfactory erectile function is similarly high. When compared to conventional RC, PSC-RC is associated with improved functional outcomes. In our patient series, oncologic outcomes are similar to conventional RC techniques with improved erectile and urinary function. CONCLUSIONS: PCS-RC is associated with improved erectile function and continence when compared to more conventional RC techniques. Our video describes a PCS-RC technique with modified W-pouch orthotopic neobladder reconstruction. Source of Funding:- © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e806 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher Dall More articles by this author Charlotte Goldman More articles by this author James Mason More articles by this author Lisa Chuong More articles by this author Keith Kowalczyk More articles by this author Lambros Stamatakis More articles by this author Ross Krasnow More articles by this author Expand All Advertisement PDF DownloadLoading ...