Genital system infiltration in women treated by radical cystectomy due to carcinoma of the bladder
Article published in Urologia Polska 2002/55/3.
Zbigniew Wolski, Magdalena Mikulska-Jovanović
- Katedra i Klinika Urologii Akademii Medycznej im. L. Rydygiera w Bydgoszczy
Kierownik kliniki: prof. AM dr hab. Zbigniew Wolski
bladder, carcinoma, cystectomia, genital system
- Introduction. Frequency and range of genital system infiltration in women with bladder carcinoma have not been exactly established.
- The aim of this study is to estimate this phenomenon in women, who underwent radical cystectomy due to bladder carcinoma, as well as its correlation with some characterictics of the neoplasm.
- Material and method. Between 1995 and 2001, 45 women underwent radical cystectomy due to bladder carcinoma. Tn the majority of them pathological tumor stage was pT3b or pT4 (in 42.3% and 20%, respectively). In 49% of patients the tumor grade was G3, and 42% of patients had lymph node metastases.
- Results. Postoperative examination revealed genital system infiltration by bladder carcinoma in 7 patients (15%). Neoplasmatic infiltration of the vagina, uterus and parametrium were found only in women with bladder cancer stage pT3b (5.5%) or pT4 (77%). Patients with cancer stage pT4 (77%), grade G3 (71%) and lymph node metastases had the greatest risk of genital system infiltration. In this group of patients only one is still alive, in comparison with 2f) of 38 women (54%) without changes in the genital system.
- A high percentage of genital system infiltration by bladder carcinoma makes it impossible to leave the uterus and anterior vaginal wall as a routine during radical cystectomy.
- Genital system infiltration is a poor prognostic factor in patients with carcinoma of the bladder.
- Stage T4 of bladder tumor, grade G3 and lymph node metastases are the greatest risk factors of genital system infiltration. In women, who are qualified to ileal neohladder creation or/and genital system sparring surgery, detailed examination of the urethra, genital system and lymph nodes before and during operation are necessary.
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