Radical cystectomy with preservation of sexual function and urinary continence: description of a new technique.

OBJECTIVE To describe the original cystoprostatectomy technique which allows the preservation of sexual and urinary function in the majority of treated patients. SURGICAL TECHNIQUE The described technique presents some details that distinguish it from classic cystectomy: 1) a more efficient control of prostate venous and arterial tributaries; 2) preservation of prostatic capsule and enucleation of prostatic parenchyma, which is removed in block together with the bladder, without violating the vesical neck; 3) no manipulation of the distal urethral sphincteric complex; 4) preservation of seminal vesicles and maintenance of cavernous neurovascular bundles; 5) wide anastomosis between the ileal neobladder and the prostatic capsule. COMMENTS The proposed maneuvers allow the performance of radical cystectomy with integral preservation of distal urethral sphincter and of cavernous neurovascular bundles, without jeopardizing the oncological principles.