Pregnancy after sexuality preserving cystectomy with urinary diversion for bladder cancer: case report and review of the literature

BMC Urol. 2022 Sep 5;22(1):143. doi: 10.1186/s12894-022-01076-7.

Abstract

Background: Radical cystectomy for bladder cancer represents a high demolitive surgical procedure with a significative impact on quality of life. Sexuality preserving techniques have been proposed in order to improve functional outcomes. Although sex-sparing techniques would provide women with the chance of having pregnancy, experience is still limited when malignant conditions are considered. We report the outcomes of pregnancy and delivery in a 43-year-old woman with a Padua ileal orthotopic neobladder after robot-assisted sexuality preserving cystectomy for muscle-invasive urothelial bladder cancer performed four years earlier, at age 39.

Case presentation: Since pregnancy was confirmed, the patient had been under close urological and gynecological observation. Hydronephrosis and voiding-relating complications were reported and treated by inserting a nephrostomy tubes and indwelling bladder catheter. At the time of delivery, elective caesarian section was performed without complications.

Conclusions: Sexuality preserving cystectomy could be an option in selected and highly motivated young patients with diagnosis of bladder cancer. A multidisciplinary team of experts included gynecologists, urologists, radiologists, anesthesiologists and neonatologists is required for the optimal management of pregnancy and peripartum care in women with urinary diversion.

Keywords: Bladder cancer; Case report; Pregnancy; Robot-assisted surgery; Sex-sparing cystectomy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Cystectomy / methods
  • Female
  • Humans
  • Pregnancy
  • Quality of Life
  • Sexuality
  • Urinary Bladder Neoplasms* / pathology
  • Urinary Bladder Neoplasms* / surgery
  • Urinary Diversion* / methods