Abstract：
BACKGROUND: Bladder cancer ranks 17th in prevalence of cancer types among women, and the trend is rising. The increased risk of female sexual dysfunction (FSD) after radical cystectomy (RC) underscores the need for greater focus on preserving and mitigating FSD.
OBJECTIVE: To place greater emphasis on the importance of female sexual function (FSF) in the treatment of bladder cancer and stimulate additional research to discover more effective solutions for enhancing the overall quality of life.
METHODS: This review used a narrative approach. Previous reviews on FSF after RC have provided limited and 1-sided solutions due to the lack of research. What makes this review unique is its innovative approach: it includes all available measures curing FSD as well as comparative analyses based on experimental data, thus making the findings more comprehensive. A detailed perspective of treatments for female bladder cancer is provided, including nerve- and organ-sparing RC, robot-assisted RC, and radiotherapy. We also analyze the impact of treatments for female bladder cancer on postoperative FSD. Additionally, solutions for addressing or alleviating postoperative FSD are summarized, such as urinary diversion, vaginal reconstruction, and drug and nondrug treatment.
RESULTS: Research has suggested that robot-assisted nerve- and organ-sparing RC is promising. Moreover, orthotopic neobladder among urinary diversions without a stoma helps to maintain a positive female body image. If part of the anterior vaginal wall must be removed during RC, vaginal reconstruction can restore the dimensions with synthetic grafts and biologic scaffolds. Additionally, postoperative measures, such as vaginal laser and hormone therapy, and use of vaginal dilators and lubricants have a significant role in reducing distress caused by FSD to provide maximum relief.
CONCLUSIONS: To support FSF after RC, various interventions are needed, and urologists must focus on patient recovery while minimizing treatment impact on FSF as much as possible.
OBJECTIVE: To place greater emphasis on the importance of female sexual function (FSF) in the treatment of bladder cancer and stimulate additional research to discover more effective solutions for enhancing the overall quality of life.
METHODS: This review used a narrative approach. Previous reviews on FSF after RC have provided limited and 1-sided solutions due to the lack of research. What makes this review unique is its innovative approach: it includes all available measures curing FSD as well as comparative analyses based on experimental data, thus making the findings more comprehensive. A detailed perspective of treatments for female bladder cancer is provided, including nerve- and organ-sparing RC, robot-assisted RC, and radiotherapy. We also analyze the impact of treatments for female bladder cancer on postoperative FSD. Additionally, solutions for addressing or alleviating postoperative FSD are summarized, such as urinary diversion, vaginal reconstruction, and drug and nondrug treatment.
RESULTS: Research has suggested that robot-assisted nerve- and organ-sparing RC is promising. Moreover, orthotopic neobladder among urinary diversions without a stoma helps to maintain a positive female body image. If part of the anterior vaginal wall must be removed during RC, vaginal reconstruction can restore the dimensions with synthetic grafts and biologic scaffolds. Additionally, postoperative measures, such as vaginal laser and hormone therapy, and use of vaginal dilators and lubricants have a significant role in reducing distress caused by FSD to provide maximum relief.
CONCLUSIONS: To support FSF after RC, various interventions are needed, and urologists must focus on patient recovery while minimizing treatment impact on FSF as much as possible.
摘要：
背景：膀胱癌在女性癌症类型的患病率中排名第17位，趋势正在上升。根治性膀胱切除术（RC）后女性性功能障碍（FSD）的风险增加，强调需要更多地关注保留和减轻FSD。
目的：更加重视女性性功能（FSF）在膀胱癌治疗中的重要性，并激发更多的研究以发现更有效的解决方案来提高整体生活质量。
方法：这篇综述使用了叙事方法。由于缺乏研究，以前对RC之后的FSF的评论提供了有限且单方面的解决方案。本次审查的独特之处在于其创新方法：它包括所有可用的措施固化FSD以及基于实验数据的比较分析，从而使研究结果更加全面。提供了女性膀胱癌治疗的详细观点，包括保留神经和器官的RC，机器人辅助RC，和放射治疗。我们还分析了女性膀胱癌的治疗方法对术后FSD的影响。此外,总结了解决或减轻术后FSD的解决方案，如尿流改道，阴道重建,药物和非药物治疗。
结果：研究表明，机器人辅助的神经和器官保护RC是有希望的。此外，没有造口的尿路改道中的原位新膀胱有助于保持积极的女性身体形象。如果在RC期间必须移除部分阴道前壁，阴道重建可以用合成移植物和生物支架恢复尺寸。此外,术后措施，如阴道激光和激素治疗，使用阴道扩张剂和润滑剂在减少FSD引起的痛苦方面具有重要作用，以提供最大程度的缓解。
结论：为了支持RC后的FSF，需要各种干预措施，泌尿科医师必须关注患者的康复，同时尽可能地减少对FSF的治疗影响。
目的：更加重视女性性功能（FSF）在膀胱癌治疗中的重要性，并激发更多的研究以发现更有效的解决方案来提高整体生活质量。
方法：这篇综述使用了叙事方法。由于缺乏研究，以前对RC之后的FSF的评论提供了有限且单方面的解决方案。本次审查的独特之处在于其创新方法：它包括所有可用的措施固化FSD以及基于实验数据的比较分析，从而使研究结果更加全面。提供了女性膀胱癌治疗的详细观点，包括保留神经和器官的RC，机器人辅助RC，和放射治疗。我们还分析了女性膀胱癌的治疗方法对术后FSD的影响。此外,总结了解决或减轻术后FSD的解决方案，如尿流改道，阴道重建,药物和非药物治疗。
结果：研究表明，机器人辅助的神经和器官保护RC是有希望的。此外，没有造口的尿路改道中的原位新膀胱有助于保持积极的女性身体形象。如果在RC期间必须移除部分阴道前壁，阴道重建可以用合成移植物和生物支架恢复尺寸。此外,术后措施，如阴道激光和激素治疗，使用阴道扩张剂和润滑剂在减少FSD引起的痛苦方面具有重要作用，以提供最大程度的缓解。
结论：为了支持RC后的FSF，需要各种干预措施，泌尿科医师必须关注患者的康复，同时尽可能地减少对FSF的治疗影响。
