Current status of prostate-sparing cystectomy

Radical cystoprostatectomy includes en bloc excision of the prostate due to a high incidence of occult prostatic malignancy in patients with bladder cancer. Radical cystectomy has a considerable incidence of functional morbidity, and concerns regarding morbidity can delay initiation of cystectomy by the patient or physician, thereby affecting long-term prognosis. Some investigators have advocated prostate-sparing cystectomy to improve postoperative continence and potency rates, and enhance patient acceptance of timely cystectomy. While these prostate-sparing series describe excellent postoperative functional results, concerns are raised regarding the oncologic efficacy of this procedure. Prostate-sparing cystectomy is arguably one of the most controversial topics in the field of urology today.