Objective: This study presents our initial experience with extraperitoneal and transperitoneal laparoscopic partial cystectomy (LPC) in the treatment of benign non-urothelial bladder tumors. Methods: Eleven patients with benign non-urothelial bladder tumors underwent extraperitoneal or transperitoneal LPC. The five cases with tumors located on the anterior/anterolateral bladder wall received the extraperitoneal approach. The six cases with tumors located around the bladder dome or over the posterior bladder wall received the transperitoneal approach. Key perioperative parameters were recorded. Results: All patients underwent laparoscopic resection smoothly without requiring a conversion to a traditional open procedure, and no patient displayed perioperative complications. Pathology showed benign non-urothelial bladder tumors with normal margins in all eleven patients, including five leiomyoma cases, three pheochromocytoma cases, two paraganglioma cases and one inflammatory fibrous histiocytoma case. Follow-up cystoscopy and imaging studies in all eleven patients (mean follow-up period 32 months) revealed neither residual nor local recurrence. Conclusions: LPC is safe and feasible in select patients with benign non-urothelial bladder tumors and yields satisfactory oncological and functional results. Extraperitoneal LPC should be preferred for lesions located on the anterior/anterolateral bladder wall, while transperitoneal LPC should be preferred for lesions around the bladder dome or over the posterior bladder wall.

Keywords:
Laparoscopy, Cystectomy, Bladder tumor
1.
Babjuk M, Burger M, Zigeuner R, Shariat SF, van Rhijn BW, Comperat E, Sylvester RJ, Kaasinen E, Bohle A, Palou Redorta J, Roupret M: EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2013. Eur Urol 2013;64:639-653.
2.
Wong-You-Cheong JJ, Woodward PJ, Manning MA, Sesterhenn IA: From the archives of the AFIP: neoplasms of the urinary bladder: radiologic-pathologic correlation. Radiographics 2006;26:553-580.
3.
Challacombe BJ, Rose K, Dasgupta P: Laparoscopic radical and partial cystectomy. J Minim Access Surg 2005;1:188-195.
4.
Pichler R, Heidegger I, Klinglmair G, Kroiss A, Uprimny C, Gasser RW, Schafer G, Steiner H: Unrecognized paraganglioma of the urinary bladder as a cause for basilar-type migraine. Urol Int 2014;92:482-487.
5.
De Pasquale V, Magistrelli A, Diomedi CF, Caione P: Unusual bladder mass in a 14-year-old boy: bladder paraganglioma. Urol Int 2011;86:117-120.
6.
Jurincic C, Gasser A, Metz KA, Kjelstrup T, Klippel KF: Pheochromocytoma of the urinary bladder. Urol Int 1992;48:232-234.
7.
Sweeney P, Kursh ED, Resnick MI: Partial cystectomy. Urol Clin North Am 1992;19:701-711.
8.
Nezhat CR, Nezhat FR: Laparoscopic segmental bladder resection for endometriosis: a report of two cases. Obstet Gynecol 1993;81:882-884.
9.
Mariano MB, Tefilli MV: Laparoscopic partial cystectomy in bladder cancer - initial experience. Int Braz J Urol 2004;30:192-198.
10.
Wadhwa P, Kolla SB, Hemal AK: Laparoscopic en bloc partial cystectomy with bilateral pelvic lymphadenectomy for urachal adenocarcinoma. Urology 2006;67:837-843.
11.
Milhoua PM, Knoll A, Bleustein CB, Ghavamian R: Laparoscopic partial cystectomy for treatment of adenocarcinoma of the urachus. Urology 2006;67:423.e15-423.e17.
12.
World Medical Association General Assembly: World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects (revised October 7, 2000). HIV Clin Trials 2001;2:92-95.
13.
Laufer M: Transurethral resection and partial cystectomy for invasive bladder cancer. Semin Urol Oncol 2000;18:296-299.
14.
Ricós Torrent JV, Solsona Narbon E: Surgical treatment of urinary bladder cancer. Indications, technics, and general results (in Spanish). Arch Esp Urol 1999;52:577-585.
15.
Herr HW, Scher HI: Neoadjuvant chemotherapy and partial cystectomy for invasive bladder cancer. J Clin Oncol 1994;12:975-980.
16.
Brannan W, Ochsner MG, Fuselier HA Jr, Landry GR: Partial cystectomy in the treatment of transitional cell carcinoma of the bladder. Trans Am Assoc Genitourin Surg 1977;69:97-99.
17.
Capitanio U, Isbarn H, Shariat SF, Jeldres C, Zini L, Saad F, Graefen M, Montorsi F, Perrotte P, Karakiewicz PI: Partial cystectomy does not undermine cancer control in appropriately selected patients with urothelial carcinoma of the bladder: a population-based matched analysis. Urology 2009;74:858-864.
18.
Smaldone MC, Jacobs BL, Smaldone AM, Hrebinko RL Jr: Long-term results of selective partial cystectomy for invasive urothelial bladder carcinoma. Urology 2008;72:613-616.
19.
Kassouf W, Swanson D, Kamat AM, Leibovici D, Siefker-Radtke A, Munsell MF, Grossman HB, Dinney CP: Partial cystectomy for muscle invasive urothelial carcinoma of the bladder: a contemporary review of the M. D. Anderson Cancer Center experience. J Urol 2006;175:2058-2062.
20.
Pianezza ML, Slatnik J, Evans HJ: Clear cell myomelanocytic tumour: minimally invasive treatment of a rare bladder tumour. Can Urol Assoc J 2008;2:230-234.
21.
Tai HC, Chung SD, Wang SM, Chueh SC, Yu HJ: Laparoscopic partial cystectomy for various bladder pathologies. BJU Int 2007;100:382-385.
22.
Nezhat CH, Malik S, Osias J, Nezhat F, Nezhat C: Laparoscopic management of 15 patients with infiltrating endometriosis of the bladder and a case of primary intravesical endometrioid adenosarcoma. Fertil Steril 2002;78:872-875.
23.
Spiess PE, Correa JJ: Robotic assisted laparoscopic partial cystectomy and urachal resection for urachal adenocarcinoma. Int Braz J Urol 2009;35:609.
24.
Tareen BU, Mufarrij PW, Godoy G, Stifelman MD: Robot-assisted laparoscopic partial cystectomy and diverticulectomy: initial experience of four cases. J Endourol 2008;22:1497-1500.
25.
Kang SG, Kang SH, Choi H, Ko YH, Park HS, Cheon J: Robot-assisted partial cystectomy of a bladder pheochromocytoma. Urol Int 2011;87:241-244.
26.
Kozlowski PM, Mihm F, Winfield HN: Laparoscopic management of bladder pheochromocytoma. Urology 2001;57:365.
27.
Geol H, Kim DW, Kim TH, Seong YK, Cho WY, Kim SD, Lee KS, Sung GT: Laparoscopic partial cystectomy for schwannoma of urinary bladder: case report. J Endourol 2005;19:303-306.
28.
Nada W, Parker J, Wong F, Cooper M, Reid G: Laparoscopic excision of endocervicosis of the urinary bladder. J Am Assoc Gynecol Laparosc 2000;7:135-137.
29.
Yamamoto M, Minikel L, Zaritsky E: Laparoscopic 5-mm trocar site herniation and literature review. JSLS 2011;15:122-126.
30.
Evans JM, Karram MM, Mahdy A, Robertshaw D: Urinary tract injury at the time of laparoscopic and robotic surgery: presentation and management. Female Pelvic Med Reconstr Surg 2013;19:249-252.
31.
Greenberg JA, Einarsson JI: The use of bidirectional barbed suture in laparoscopic myomectomy and total laparoscopic hysterectomy. J Minim Invasive Gynecol 2008;15:621-623.
© 2014 S. Karger AG, Basel
2014
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.