Application of Intrafascial Neurovascular Bundle Spare Technique in Radical Cystectomy

Objective: To investigate the significance of intrafascial neurovascular bundle spare technique in radical cystectomy. Methods: Between March 2010 and December 2011, a total of 26 bladder cancer patients were treated with radical cystectomy, and intrafascial neurovascular bundle spare technique was applied in all these patients. Mean age of 26 patients was 56.1 y (45 - 66). Among 26 patients, 21 cases were in stage T2, 5 cases were in stage T3. All patients choose Orthotopic neobladder as urinary diversion manner. We use intrafascial neurovascular bundle spare technique, dissect between prostatic fascial and prostatic capsule, spare neurovascular bundle. Operating time, blood loss, complications, continence and sexual function 3 months after surgery were recorded. Results: In all patients, mean operating time was 328 min, mean blood loss was 316 ml. Only 4 patients need transfusion during surgery. 1 case of urinary fistula was found after surgery, and spontaneously cured 10 days after surgery. 1 case of bowel obstruction was found, and was cured by conservative therapy. 4 cases of incontinence were found 3 months after surgery. 18 patients had a nomal erectile function 3 months after surgery. Conclusions: Intrafascial neurovascular bundle spare technique can safely and effectively reserve neurovascular bundle in radical cystectomy. Patients can reserve continence and erectile function by this technique.