الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Data in the literature were limited about long term outcome of Nerve sparing cystectomy as there was no matching with regard age and pathological stage, which is a substantial confounding variable. Moreover, the limited number of patients in one study and the deficit in long-term follow-up constitutes a profound shortcoming. this study is conduct to compare the difference in long-term oncological as well as the functional outcomes and health related quality of life between patients underwent NSCP compared to an age and pathological stage with conventional cystectomy group. METHODS: A retrospective analysis was performed for patients who underwent NSRC and have completed at least 4 years at time of last follow-up. Patients with selected age (:S60), very good pre-operative sexual and continence status were included. Patients who underwent ileal loop diversion were excluded. Patients at time of last follow-up were evaluated by the international index of erectile function questionnaire (IIEF), BCI urinary domain questionnaire and health related quality of life (EROTIC - Q30) questionnaire. Recoverability of erectile function was determined by IIEF-EF domain> 25 at time of last follow-up. Continence was defined by complete dry and full control of urine. RES UL TS: Between 1993 and December 2015, a total of 5500 patients underwent open radical cystectomy (NSRC or Open ) of whom 734 patients met the study inclusion criteria. Oncological failure reported in 192 (26.2 %) patients. So a total of 481 evaluable patients were free of disease at last follow up. The mean + SD age at time of surgery was 52 ± 5.9, 51.28 ± 6.1 years with a mean follow up period of 7 years in nerve sparing and conventional cystectomy group, respectively. Post-operative Potency rates were 67% in NSCG. Day time continence is 91.2 % vs 79.8% in the NSCG and CCG, respectively while night continence is 80 % vs 41.2 % between the groups also. The quality of live scores are highly significant in NSCG with P. value in Global Health Status 0.001. The long term oncological outcome is not significant different in local recurrence rate P. value 0.07 and in cancer specific at 5 years were 65.5% and 67.7 % survival P. value 0.8. Conclusions: Nerve sparing radical cystectomy is feasible, effective and highly recommended technique for young patients who undergoing radical cystectomy. With good sexual, continence and quality of life functions but with strict selection of the patient stage of disease due to narrow window between success and failure.