Download Urethra-Sparing is Contraindicated in Radical Cystoprostatectomy

Urethra-Sparing is Contraindicated
in Radical Cystoprostatectomy for
TCCA of the Bladder
Point/Counterpoint
No: Bernard B. Bochner, M.D.
(Urethra-Sparing SHOULD be done)
Yes: Douglas S. Scher, M.D.
(Urethra-Sparing should NOT be done)
Moderator: Michael J. Droller, M.D.
Definition of the Debate
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Define histopathologic findings to consider
Describe clinical scenarios that determine impressions
Identify outcomes that guide refinements of opinions
Consider risks, benefits, advantages and disadvantages
of each approach
Conclude to agree or disagree, establish boundaries,
and understand areas for further study
Topics for Discussion
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Histopathologic aspects of transitional cell
cancer of the bladder that introduce the
issue of urethrectomy vs a urethra-sparing
approach
 Clinical considerations
 Definition of urethra-sparing approaches
and surgical considerations (including open
surgery vs laparoscopy/robotics)
Topics for Discussion
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Risks and side effects of urethrectomy vs urethrasparing surgery
Advantages and disadvantages of urethrectomy vs
urethra-sparing surgery
Manner of follow-up and its reliability
Considerations of early vs delayed urethrectomy
Outcomes of cystectomy with or without
urethrectomy in various histopathologic and clinical
settings
Schedule of Debate
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Bochner (8-9 minutes):
Urethra-sparing should be done
Scher (8-9 minutes):
Urethra-sparing should not be done
Bochner (2-3 minutes):
Rebuttal
Scher (2-3 minutes):
Rebuttal
Droller: Summary and Conclusions