RC significantly negatively impacts sexual function (SF) in both men and women. While significant research resources have been allocated to examine the deleterious effects of post prostatectomy erectile dysfunction, little attention has been directed towards female sexual function and organ preservation post cystectomy.
These academic shortcomings often result in poor provider awareness and inadequate preoperative assessment. As such, it is crucial for all providers involved in female RC care to understand the necessary and available tools for preoperative evaluation, in addition to the anatomic and reconstructive techniques. This review aims to summarize the current preoperative evaluation and available tools of SF assessment and describe in detail the varying operative techniques in the preservation or restoration of SF in women after RC. The review explores the intricacies of preoperative evaluation tools, and intraoperative techniques for organ- and nerve-sparing during radical cystectomy in females. Particular emphasis on vaginal reconstruction after partial or complete resection is provided, including split-thickness skin (STF) graft vaginoplasy, pedicled flaps, myocutaneous flaps and use of bowel segments. In conclusion, this narrative review highlights the importance of understanding anatomic considerations and nerve-sparing strategies in promoting postoperative SF and quality of life. Furthermore, the review describes the advantages and limitations of each organ- and nerve-sparing technique and their impact on sexual function and overall well-being.
World journal of urology. 2023 Jul 07 [Epub ahead of print]
Peace Orji, Helen Sun, Ilaha Isali, Spencer Bell, Nicholas Zaorsky, Kirtishri Mishra, Shubham Gupta, Andres Correa, Marc Smaldone, Adam Calaway, Rosalia Viterbo, Laura Bukavina
Case Western Reserve School of Medicine, Cleveland, OH, USA., Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA., Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/37419972
Go Beyond the Abstract and Read a Commentary by the Authors