Neurovascular preservation in orthotopic cystectomy

Impact on female sexual function

Amit Bhatt, Kalyana C. Nandipati, Nivedita Dhar, James Ulchaker, Stephen Jones, Raymond Rackley, Craig Zippe

Research output: Contribution to journalArticle

44 Citations (Scopus)

Abstract

Objectives: The published data regarding female orthotopic cystectomy have focused primarily on urethral recurrence and urinary continence. In a new era of sexuality, evaluating postoperative sexual outcome has become a new surgical endpoint. In this study, we focused on the impact of neurovascular preservation after radical cystectomy and neobladder construction. Methods: We assessed female sexuality in 13 patients after orthotopic cystectomy using a standardized questionnaire, Female Sexual Function Index (FSFI). Six patients had undergone nerve-sparing cystectomy and seven had undergone contemporary non-nerve-sparing cystectomy. Intraoperatively, the tumor was deemed oncologically safe for neurovascular preservation. All 13 patients were sexually active preoperatively, were younger than 65 years old, had recurrence-free follow-up findings after 1 year, and had undergone no pelvic irradiation. The 19-item FSFI questionnaire analyzed six domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) of sexual function. Results: In the nerve-sparing group (mean age 55.9 years), the baseline and 12-month postoperative scores showed a minimal decline in results, with a total mean FSFI score of 24.5 versus 22.3, respectively. In analyzing each of the six domains, no significant decline or difference was observed. Conversely, in the non-nerve-sparing group (mean age 56.7 years), a significant decline or difference was found in the 12-month total mean FSFI scores between the baseline and postoperative FSFI scores (25.0 versus 11.0, respectively). In the non-nerve-sparing group, 6 of 7 patients ultimately discontinued sexual intercourse. Conclusions: Female sexual function was preserved in patients who received neurovascular preservation. In contrast, all domains of sexual function declined in patients who had undergone non-neurovascular preservation.

Original languageEnglish
Pages (from-to)742-745
Number of pages4
JournalUrology
Volume67
Issue number4
DOIs
StatePublished - Apr 2006
Externally publishedYes

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Cystectomy
Orgasm
Sexuality
Age Groups
Lubrication
Recurrence
Coitus
Arousal
Pain

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Neurovascular preservation in orthotopic cystectomy : Impact on female sexual function. / Bhatt, Amit; Nandipati, Kalyana C.; Dhar, Nivedita; Ulchaker, James; Jones, Stephen; Rackley, Raymond; Zippe, Craig.

In: Urology, Vol. 67, No. 4, 04.2006, p. 742-745.

Research output: Contribution to journalArticle

Bhatt, A, Nandipati, KC, Dhar, N, Ulchaker, J, Jones, S, Rackley, R & Zippe, C 2006, 'Neurovascular preservation in orthotopic cystectomy: Impact on female sexual function', Urology, vol. 67, no. 4, pp. 742-745. https://doi.org/10.1016/j.urology.2005.10.015
Bhatt, Amit ; Nandipati, Kalyana C. ; Dhar, Nivedita ; Ulchaker, James ; Jones, Stephen ; Rackley, Raymond ; Zippe, Craig. / Neurovascular preservation in orthotopic cystectomy : Impact on female sexual function. In: Urology. 2006 ; Vol. 67, No. 4. pp. 742-745.
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