Female Sexual Function Following Radical Cystectomy in Bladder Cancer. 2022

Laura Davis, and Ilaha Isali, and Megan Prunty, and Adam Calaway, and Kirtishri Mishra, and April Miller, and Rachel Pope, and Diana Magee, and Alberto Castro Bigalli, and Nannan Thirumavalavan, and Lee Ponsky, and Laura Bukavina
Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

A clear and well-documented gender bias exists in the evaluation of sexual outcomes for women undergoing urologic surgery. Due to the anatomic template of anterior exenteration, women are commonly left with side effects that include sexual dysfunction and the perpetuated effects of surgical menopause. To present evaluation and treatment recommendations for female sexual dysfunction treatment and evaluation, in addition to surgical templates during radical cystectomy (RC). This article reviews current literature regarding sexual function and RC with urinary diversion in female bladder cancer patients. Furthermore, this review will provide a review of techniques for organ and neurovascular preservation, along with novel vaginal reconstruction templates. Our review will further focus on emerging technology, including minimally invasive surgery and organ and nerve preservation, directed at preservation of female sexual function. Clinically, studies have demonstrated that females who have undergone genitalia-sparing and neurovascular preservation during RC regained sexual activity earlier than patients undergoing traditional RC. If organ and nerve preservation is not feasible due to involvement of trigone or bladder neck, vaginal reconstruction can mitigate the sexual dysfunction that results from a loss of the anterior vagina during a standard RC. Female sexual dysfunction is associated with high levels of patient distress and is best comanaged with a multidisciplinary treatment approach, including preoperative counseling, intraoperative nerve, and organ preservation, and postoperative interventions to mitigate sexual side effects. Davis L, Isali I, Prunty M, et al. Female Sexual Function Following Radical Cystectomy in Bladder Cancer. Sex Med Rev 2022;10:231-239.

UI MeSH Term Description Entries
D008297 Male Males
D001743 Urinary Bladder A musculomembranous sac along the URINARY TRACT. URINE flows from the KIDNEYS into the bladder via the ureters (URETER), and is held there until URINATION. Bladder,Bladder Detrusor Muscle,Detrusor Urinae,Bladder Detrusor Muscles,Bladder, Urinary,Detrusor Muscle, Bladder,Detrusor Muscles, Bladder
D001749 Urinary Bladder Neoplasms Tumors or cancer of the URINARY BLADDER. Bladder Cancer,Bladder Neoplasms,Cancer of Bladder,Bladder Tumors,Cancer of the Bladder,Malignant Tumor of Urinary Bladder,Neoplasms, Bladder,Urinary Bladder Cancer,Bladder Cancers,Bladder Neoplasm,Bladder Tumor,Cancer, Bladder,Cancer, Urinary Bladder,Neoplasm, Bladder,Neoplasm, Urinary Bladder,Tumor, Bladder,Tumors, Bladder,Urinary Bladder Neoplasm
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012735 Sexual Dysfunction, Physiological Physiological disturbances in normal sexual performance in either the male or the female. Sex Disorders,Sexual Disorders, Physiological,Sexual Dysfunctions, Physiological,Physiological Sexual Disorder,Physiological Sexual Disorders,Physiological Sexual Dysfunction,Physiological Sexual Dysfunctions,Sexual Disorder, Physiological
D014547 Urinary Diversion Temporary or permanent diversion of the flow of urine through the ureter away from the URINARY BLADDER in the presence of a bladder disease or after cystectomy. There is a variety of techniques: direct anastomosis of ureter and bowel, cutaneous ureterostomy, ileal, jejunal or colon conduit, ureterosigmoidostomy, etc. (From Campbell's Urology, 6th ed, p2654) Ileal Conduit,Conduit, Ileal,Conduits, Ileal,Diversion, Urinary,Diversions, Urinary,Ileal Conduits,Urinary Diversions
D015653 Cystectomy Surgical removal of the full or partial removal of the URINARY BLADDER. Partial Cystectomy,Radical Cystectomy,Cystectomies,Cystectomy, Partial,Cystectomy, Radical,Partial Cystectomies,Radical Cystectomies
D063507 Sexism Prejudice or discrimination based on gender or behavior or attitudes that foster stereotyped social roles based on gender. Gender Bias,Gender Discrimination,Sex Bias,Sexual Discrimination,Gender Issues,Sex Discrimination,Bias, Gender,Bias, Sex,Discrimination, Gender,Discrimination, Sex,Discrimination, Sexual

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