Muscle Invasive Bladder Cancer

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Prostate/SV Sparing?• Pros – optimized continence and potency• Cons– Urothelial carcinoma of the prostate 40%– Prostatic adenocarcinoma 40%• ≥50% clinically significant
What About Prostate ApicalSparing?• Rationale: Essential role of the prostaticapex for continence and the location of theautonomic nerves in this region• Apex-sparing approach may be a treatmentoption for muscle-invasive bladder cancer• But, Gakis, et al (BJUI 105:468, 2009)– 7/95 (7.3%) prostate cancer in the apex
Page 1: Open Radical Cystectomy Tips andTri
Page 7: Radical CystectomyHow Much to Take?
Page 13 and 14: Mobilize theSigmoid Mesentery• Di
Page 15 and 16: Is there a stage benefit in perform
Page 17 and 18: Is there a stage benefit in perform
Page 19 and 20: PLND BoundariesStandard Dissection
Page 21 and 22: Pre-Sciatic Fossaaka Fossa of Marse
Page 23: Tuttle (Singley) forceps
Page 28: Expose the External Iliac Vessels
Page 32: Lateral pedicle• The lymph nodebe
Page 42 and 43: Rationale for ExtendedPelvic and Il
Page 45 and 46: Transurethral resection biopsy of t
Page 47: TUR Prostatic Urethra and ApicalUre
Page 51: Female Urethra SparingIndications
Page 55 and 56: Opening Posterior VaginaUterusCervi
Page 57 and 58: Preserve Distal Anterior VaginaUret
Page 59 and 60: Division of UrethraUrethraBladder n
Page 61 and 62: Using the Omentum• Cover the abdo
Page 64 and 65: Secure pedicle to levator muscles w
Page 66: Summary• Pre-sciatic (Fossa of Ma

Muscle Invasive Bladder Cancer

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