sodium-ethylxanthate and Urinary-Bladder-Neoplasms

Topics: Adult; Aged; Black or African American; Black People; England; Environmental Exposure; Female; Humans; Japan; Male; Middle Aged; Occupational Diseases; Prospective Studies; Sex; Smoking; United States; Urinary Bladder Neoplasms; White People

We retrospectively evaluated the outcome of Hautmann neobladder reconstruction in terms of complications, lower urinary tract symptoms, and sexual function in a large group of patients who underwent radical cystectomy.. We reviewed the medical records of 118 patients (105 men and 13 women) who underwent radical cystectomy and Hautmann neobladder construction at the Gifu University Hospital or one of its affiliate hospitals between Jan 1993 and Dec 1999. The 118 patients were asked to complete a questionnaire regarding lower urinary tract symptoms and sexual activity, and the data was compiled.. The mean follow-up period was 50.4 months (range, 6.8-88.2). Early complications comprised wound infection (in 17.8% of patients) and ileus (in 10.1% of patients). Late complications comprised ileus, pyelonephritis, stone, and stricture of the pouch-urethral anastomosis, each of which occurred in 3.4% of patients. Eighty-one (73 men and 8 women, 72.9%) of 90 surviving patients replied to the questionnaire. Seventy-seven (95.1%) of these patients reported spontaneous micturition, whereas 4 (4.9%) patients required intermittent self-catheterization. The mean total I-PSS was 11.6 points. Twenty-five percent of patients experienced interrupted voiding almost always; 38% of patients did not experience this at all. Approximately 26% of patients experienced weak urinary streams; 36% did not. Daytime continence was achieved in 97.3% of patients; nighttime incontinence was present in 61.3%. Preoperatively, 79.7% of the men were capable of sexual intercourse. Postoperatively, 63.6% of men who underwent radical cystectomy with the nerve-sparing procedure were capable of sexual intercourse, whereas only 14.8% of men who underwent radical cystectomy without the nerve-sparing procedure were.. Morbidity rates were acceptable and functional outcome was excellent in this rather large group of patients who underwent Hautmann neobladder construction. Some problems have not been fully overcome, however, i.e., nocturnal incontinence and sexual dysfunction.

Topics: Adult; Aged; Aged, 80 and over; Cystectomy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Sex; Surveys and Questionnaires; Treatment Outcome; Urinary Bladder Neoplasms; Urinary Diversion; Urinary Incontinence; Urination

Between 1980-1989 a total of 349 patients underwent one-stage radical cystoprostatectomy and an orthotopic bladder substitution. 278 patients underwent the Camey I bladder replacement and in 71 patients a detubularized ileal loop was utilized (Camey II). 75 patients underwent a potency-sparing cystectomy (32 patients of the Camey I and 43 patients of the Camey II groups). All patients were followed at least one year and had continence and potency assessment. Among the patients who underwent the Camey I procedure, 66% achieved daytime continence and 21% night-time continence 6 months after surgery. One year after surgery 86% of patients had normal continence during the day and 47% was continent during the night. 14% of patients had episodes of day-time incontinence one year after surgery. Among the patients who underwent the Camey II bladder replacement 86% achieved day-time continence and 59% night-time continence 6 months after surgery. At one year after surgery 91% was continent during the day, 72% was dry during the night and only 9% had episodes of diurnal incontinence. Potency was achieved in 24 of 32 patients (75%) with the Camey I bladder substitution, and in 34 of the 43 patients (79%) with the Camey II bladder substitution. Our data demonstrate that excellent rates of continence and potency are achievable in the post-cystectomy population. Patients with the Camey II bladder replacement achieve continence earlier than patients with the Camey I bladder substitution. Diurnal continence is slightly better after the Camey II procedure, one year after surgery, but the difference is not statistically significant. Nocturnal continence is significantly better with the Camey II bladder substitution.

Topics: Adult; Aged; Aged, 80 and over; Cystectomy; Humans; Male; Middle Aged; Prostatectomy; Sex; Urinary Bladder Neoplasms; Urinary Incontinence; Urinary Reservoirs, Continent; Urination

With the advent of effective treatment for urologic cancer, the preservation of sexual function and fertility has become an important goal. Some cancer treatments damage the physiological systems involved in reproduction. All have a psychological impact on sexuality. For men with prostate cancer, current issues in sexual rehabilitation include the debate on nerve-sparing radical prostatectomy, the role of vascular damage in causing erectile dysfunction after radiotherapy, and the need for a better understanding of hormonal effects on central and peripheral mechanisms of sexual function. In the treatment of men and women with bladder cancer, the sexual function morbidity of radical cystectomy is described in data from prospective interview studies. Sexual desire and orgasm remain normal after surgery despite disruption of the genital vasocongestion accompanying sexual arousal. Long-term follow-up studies of testicular cancer patients suggest that some increase in sexual dysfunction does occur. Infertility remains a concern for a subgroup of younger, childless men. Attempts to modify or eliminate retroperitoneal lymphadenectomy are discussed, as is recovery of spermatogenesis after chemotherapy and radiotherapy. Sexual function in patients with penile, urethral, or renal cell carcinoma is briefly reviewed.

Topics: Adult; Counseling; Dysgerminoma; Female; Fertility; Genital Neoplasms, Male; Humans; Kidney Neoplasms; Male; Middle Aged; Neoplasms, Germ Cell and Embryonal; Penile Neoplasms; Prostatectomy; Prostatic Neoplasms; Sex; Testicular Neoplasms; Urinary Bladder Neoplasms; Urogenital Neoplasms

Topics: Aorta, Abdominal; Female; Genital Diseases, Female; Humans; Iliac Artery; Prostatectomy; Rectum; Sex; Sympathectomy; Ureter; Urinary Bladder Neoplasms

Topics: Aging; Burkitt Lymphoma; Gastrointestinal Neoplasms; Humans; Laryngeal Neoplasms; Liver Neoplasms; Lung Neoplasms; Lymphoma; Male; Mozambique; Neoplasms; Paranasal Sinus Neoplasms; Penile Neoplasms; Sex; Urinary Bladder Neoplasms

Topics: Biometry; Epidemiology; Humans; Sex; Smoking; Statistics as Topic; United States; Urinary Bladder Neoplasms

Topics: Adult; Aged; Aging; Breast Neoplasms; Female; Gastrointestinal Neoplasms; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasms; Sex; Urinary Bladder Neoplasms

Topics: Coloring Agents; Cystitis; Epidemiology; Ethnology; Geriatrics; Humans; Neoplasms; New York; Occupational Diseases; Occupations; Schistosomiasis; Sex; Smoking; Statistics as Topic; Urinary Bladder Calculi; Urinary Bladder Neoplasms