Objective: To evaluate cystectomy with preservation of the prostate in the treatment of bladder tumours.
Material and methods: A review of the literature (Medline, key words: cancer, bladder, cystectomy, prostate, urinary incontinence, sexual impotence) was performed. Three cystectomy techniques with preservation of the prostate were recently described; their anatomical basis, surgical techniques and indications are reported. Their morbidity and oncological and functional results were then studied and compared to contemporary total cystectomy series.
Results: The morbidity is not worsened. The functional results were globally improved, especially in terms of erectile function. In terms of cancer control, local recurrences were not more frequent, but metastatic recurrence rates appeared to be higher.
Conclusion: Compared to total cystectomy, cystectomy with preservation of the prostate is not associated with increased morbidity, improves functional results, but does not appear to ensure an equivalent level of cancer control.