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Surgical Innovation for Invasive Bladder Cancer Treatments

Image diagramming the location of the superior vesical pedicle and seminal vesicle

Physician scientists at the Bladder Cancer Research Center are interested in surgical techniques that improve outcomes and spare functioning in patients with bladder cancer

Outcomes of Nerve-Sparing Cystoprostatectomy and Neobladder Bladder Reconstruction  

Discoveries by Dr. Patrick C. Walsh defined the location of nerves that are responsible for potency in men. Years of surgical research and anatomic studies of the location of these nerves have allowed for the development of a highly emulated technique for nerve-sparing removal in men. Complete cystoprostatectomy preserves potency in patients undergoing major surgery for bladder cancer. 

Neurovascular Bundle diagramNeuroanatomical approach to radical cystoprostatectomy with preservation of sexual function. J Urol 1987;138(6):1402-1406.

 

The disease-specific survival of men undergoing this type of surgery as well as data on potency after the operation appear below:

Johns Hopkins Hospital disease specific survival ratesLocal recurrence and survival following nerve sparing radical cystoprostatectomy for bladder cancer: 10-year follow-up. J Urol 1996;155(2):490-494.
Postoperative potency status of 78 evaluable patients listed by pathological stage and age group at time of surgery (No. potent/No. evaluable)
Stage20-29
years
30-3940-4950-5960-6970-79Totals
PO--2/25/72/5-9/14      64%
PA--1/3--1/32/6      33%
PIS--0/12/53/100/15/17      22%
P1--2/31/42/6-5/13      30%
P2--2/21/21/1-4/5      80%
P3A1/1-1/21/10/10/12/5      40%
P3B--0/31/42/51/45/17      29%
P4---1/1--1/1      100%
Totals1/1
100%
-8/16
50%
12/14
50%
11/31
35%
1/6
17%
 

Innovative Surgical Techniques are Routine at Johns Hopkins 

The surgical intervention for invasive bladder cancer is routine and well organized at the Johns Hopkins Brady Urological Institute. Faculty and staff complete preoperative consultation, imaging, endoscopic evaluation and expert review of biopsy material, laboratory and X-ray data. Our surgeons routinely perform all forms of urinary tract reconstruction, including ileal conduit, catheterizable continent diversion pouch and orthotopic neobladder reconstruction. 

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