摘要 During radical cystectomy (RC), the neurovascular bundles are easily removed or damaged, leading to varying rates of incontinence and erectile dysfunction. The nervesparing technique was developed to preserve urinary and erectile function. The adoption of laparoscopic and robot-assisted technology has improved visualization and dexterity of pelvic surgeries, thus facilitate the nerve-sparing technique. Although nerve-sparing RC is technically similar with nerve-sparing radical prostatectomy, there are still some anatomical differences. There are mainly three different types of nerve-sparing techniques. Pelvic lymph node dissection (PLND) is another important factor to influence erectile function and urinary continence. Nerve-sparing laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) may be an optimal treatment choice in well-selected younger patients with lowvolume, organ-confined disease. We should attempt to do, whenever possible, a nerve-sparing cystectomy at least on oneside. However, due to the need of a well-refined surgical technique, nerve-sparing LRC and RARC is now being performed only by experienced urological surgeons.
Abstract: During radical cystectomy (RC), the neurovascular bundles are easily removed or damaged, leading to varying rates of incontinence and erectile dysfunction. The nervesparing technique was developed to preserve urinary and erectile function. The adoption of laparoscopic and robot-assisted technology has improved visualization and dexterity of pelvic surgeries, thus facilitate the nerve-sparing technique. Although nerve-sparing RC is technically similar with nerve-sparing radical prostatectomy, there are still some anatomical differences. There are mainly three different types of nerve-sparing techniques. Pelvic lymph node dissection (PLND) is another important factor to influence erectile function and urinary continence. Nerve-sparing laparoscopic radical cystectomy (LRC) and robot-assisted radical cystectomy (RARC) may be an optimal treatment choice in well-selected younger patients with lowvolume, organ-confined disease. We should attempt to do, whenever possible, a nerve-sparing cystectomy at least on oneside. However, due to the need of a well-refined surgical technique, nerve-sparing LRC and RARC is now being performed only by experienced urological surgeons.
基金资助: This review is supported by Yat-sen Clinical Trail Project
(No. 200501).
引用本文:
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