000			04515nam a22006017a 4500
008			240723s20242024 xxu||||| |||| 00| 0 eng d
022			_a1078-1439
024			_aS1078-1439(24)00009-7 [pii]
040			_aOvid MEDLINE(R)
099			_a38418269
245			_aFunctional and oncologic outcomes of prostate capsule-sparing radical cystectomy: A systematic review and meta-analysis. [Review]
251			_aUrologic Oncology. 42(5):121-132, 2024 May.
252			_aUROL. ONCOL.. 42(5):121-132, 2024 May.
253			_aUrologic oncology
260			_c2024
260			_p2024 May
260			_fFY2024
265			_sppublish
265			_tMEDLINE
520			_aRadical cystectomy (RC) is the gold standard treatment for patients with organ-confined bladder cancer. However, despite the success of this treatment, many men who undergo orthotopic neobladder substitution develop significant erectile dysfunction and urinary symptoms, including daytime and nighttime urinary incontinence. Prostate-capsule-sparing radical cystectomy (PCS-RC) with orthotopic neobladder (ONB) has been described in the literature as a surgical technique to improve functional outcomes in appropriately selected patients. We performed a systematic review and meta-analysis of manuscripts on PCS-RC with ONB published after 2000. We included retrospective and prospective studies with more than 25 patients and compared PCS-RC with nerve-sparing or conventional RC. Studies in which the entire prostate was spared (including the transitional zone) were excluded. Comparative studies were analyzed to assess rates of daytime continence, nighttime continence, and satisfactory erectile function in patients undergoing PCS-RC compared with those undergoing conventional RC. Fourteen reports were included in the final review. Our data identify high rates of daytime (83%-97%) and nighttime continence (60%-80%) in patients undergoing PCS-RC with ONB. In comparative studies, meta-analysis results demonstrate no difference in daytime continence (RR:1.12; 95% CI: 0.72-1.73) in those undergoing PCS-RC compared to those undergoing conventional RC. Similarly, nighttime continence was similar between the 2 groups (RR:1.85; 95% CI: 0.57-6.00. Erectile function was improved in those undergoing PCS-RC (RR 5.35; 95% CI: 1.82-15.74) in the PCS-RC series. Bladder cancer margin positivity and recurrence rates were similar to those reported in the literature with conventional RC with an average weighted follow-up of 52.2 months. While several studies utilized different prostate cancer (CaP) screening techniques, the rates of CaP were low (incidence 0.02; 95% CI:0.01-0.04), and oncologic outcomes were similar to standard RC. PCS-RC is associated with improved nighttime continence and erectile function compared to conventional RC techniques. Further work is needed to standardize CaP screening before surgery, but the data suggest low rates of CaP with similar oncologic outcomes when compared to RC. Copyright © 2024 Elsevier Inc. All rights reserved.
546			_aEnglish
650			_a*Erectile Dysfunction
650			_a*Urinary Bladder Neoplasms
650			_aCystectomy/mt [Methods]
650			_aErectile Dysfunction/et [Etiology]
650			_aErectile Dysfunction/su [Surgery]
650			_aHumans
650			_aMale
650			_aProspective Studies
650			_aProstate/su [Surgery]
650			_aRetrospective Studies
650			_aTreatment Outcome
650			_aUrinary Bladder Neoplasms/et [Etiology]
650			_zAutomated
651			_aMedStar Health Research Institute
651			_aMedStar Washington Hospital Center
656			_aMedStar Georgetown University Hospital/MedStar Washington Hospital Center
656			_aUrology
656			_aUrology Residency - Categorical
657			_aJournal Article
657			_aMeta-Analysis
657			_aReview
657			_aSystematic Review
700			_aChou, JiLing _bMHRI
700			_aDall, Christopher P _bMWHC
700			_aGoldman, Charlotte _bMGUH _cUrology Residency - Categorical _dMD
700			_aKrasnow, Ross E _bMWHC
700			_aMason, James _bMGUH _cUrology Residency - Categorical _dMD
700			_aStamatakis, Lambros _bMWHC
790			_aDall CP, Mason JB, Goldman CC, Fabrizio G, Alagha EC, Chou J, Kowalczyk KJ, Agarwal PK, Stamatakis L, Krasnow RE
856			_uhttps://dx.doi.org/10.1016/j.urolonc.2024.01.008 _zhttps://dx.doi.org/10.1016/j.urolonc.2024.01.008
942			_cART _dArticle
999			_c14308 _d14308