Editing Muscle-Invasive Bladder Cancer (section)

====Sexual function preserving procedures====
*'''Should be considered for patients with organ-confined disease and absence of bladder neck, urethra, and prostate (male) involvement.'''

*Nerve-sparing should be discussed and offered in all patients who desire sexual function preservation and are sexually active, as long as it will not compromise oncologic control.
* Prostate-sparing and prostate-capsule sparing cystectomy in males
**May be offered to highly select males with negative prostatic urethral and transrectal prostate biopsies in whom fertility and sexual function are important considerations.
** Nerve sparing procedures in males may offer similar rates of sexual function preservation when compared to prostate-sparing cystectomy.
*'''Vaginal sparing radical cystectomy in females'''
**'''Can be performed when doing so will not compromise tumor control, such as in the absence of cancer in the trigone or bladder base.'''
**'''Consideration may also be given to preserving the ovaries for hormonal homeostasis, and the anterior vaginal wall and/or uterus may be preserved in the absence of direct tumor extension.'''