Is Anterior Exenteration Necessary in Women Undergoing Radical Cystectomy?

Özet

Objective: Radical cystectomy is the gold standard for the treatment of muscle-invasive bladder cancer. Anterior exenteration with cystectomy is standard practice in female patients. In this study, we aimed to evaluate the necessity of anterior exenteration in female patients who underwent cystectomy for invasive bladder cancer. Materials and Methods: Thirty-one women who underwent open radical cystectomy for bladder cancer between January 2010 and July 2018 were included in the study. The demographic characteristics, pathology results and genital organ involvement of these cases were retrospectively analyzed. Results: The mean age of the patients was 63 (range, 33-80) years. Eleven of the cases underwent anterior exenteration with cystectomy, while only two (6%) of these cases had gynecologic organ involvement of uroepithelial origin. One patient who had positive smear sampling prior to cystectomy also had genital organ involvement in the final pathology. Conclusion: In the light of our findings, anterior exenteration during radical cystectomy is beneficial in patients with no expectation of advanced sexual function or fertility to protect them from gynecological cancers that may develop simultaneously or later. However, in young patients and patients without suspicion of invasion in preoperative evaluation, organ sparing approaches are considered appropriate.