Abstract
Background
Female reproductive organ-sparing (ROS) and nerve-sparing radical cystectomy (RC)
techniques have been shown to be oncologically safe and to improve sexual function
outcomes among select patients with organ-confined disease. We sought to characterize
practice patterns regarding female ROS and nerve-sparing RC among US urologists.
Patients and Methods
We conducted a cross-sectional survey of members of the Society of Urologic Oncology
to assess provider-reported frequency of ROS and nerve-sparing RC in premenopausal
and postmenopausal patients with non–muscle-invasive bladder cancer that failed intravesical
therapy or clinically localized muscle-invasive bladder cancer.
Results
Among 101 urologists, 80 (79.2%) reported that they routinely resect the uterus/cervix,
68 (67.3%) the neurovascular bundle, 49 (48.5%) the ovaries, and 19 (18.8%) a portion
of the vagina when performing RC in premenopausal patients with organ-confined disease.
When asked about changes to approach in postmenopausal patients, 71 participants (70.3%)
reported that they were less likely to spare the uterus/cervix, 44 (43.6%) were less
likely to spare the neurovascular bundle, 70 (69.3%) were less likely to spare the
ovaries, and 23 (22.8%) were less likely to spare a portion of the vagina.
Conclusion
We identified significant gaps in adoption of female ROS and nerve-sparing RC techniques
for patients with organ-confined disease, despite evidence that ROS and nerve-sparing
techniques are oncologically safe and can optimize functional outcomes in select patients.
Future efforts should improve provider training in and education about ROS and nerve-sparing
RC to improve postoperative outcomes among female patients.
Keywords
Abbreviations:
AUA (American Urological Association), CI (confidence interval), IQR (interquartile range), MIBC (muscle-invasive bladder cancer), NMIBC (non–muscle-invasive bladder cancer), RC (radical cystectomy), ROS (reproductive organ-sparing), RR (relative risk), SUO (Society of Urologic Oncology)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 26, 2023
Accepted:
January 22,
2023
Received in revised form:
January 16,
2023
Received:
November 8,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
Published by Elsevier Inc.
