Management of the prostate and urethra in patients undergoing radical cystectomy

For individuals with muscle invasive bladder cancer, radical cystectomy has remained the gold standard for treatment. Due to the common post operative complaints in patients undergoing radical cystectomy with orthotopic neobladder formation i.e. sexual dysfunction and urinary incontinence, members of the urologic community have sought ways to ameliorate these side effects with prostate and urethra sparing surgery. This review pre-sents that topic based on the contemporary literature regarding the management of the prostate and urethra in men and women undergoing radical cystectomy for muscle invasive bladder cancer. Prostate sparing cystectomy remains controversial. Those in favor of it emphasize sub-stantial improvements in functional outcomes and the effect that it could have on patients' quality of life. Those opposed to it cite increased oncologic risk and violation of the oncologic principle of en bloc excision of at-risk organs. The most current information related to this ongoing debate is presented and discussed.