Involvement of internal genitalia in female patients undergoing radical cystectomy for bladder cancer: a clinicopathologic study of 37 cases

Radical cystectomy for invasive bladder cancer in female patients implies a nterior pelvic exenteration. The necessity for routine removal of all inter nal female genitalia has not, as yet, been investigated. The present study was conducted to investigate the involvement of internal genitalia in these patients. Cystectomy specimens from 37 consecutive female Patients with bl adder cancer were examined for internal genitalia and urethral involvement. Clinical data were retrospectively collected from hospital charts. Thirty- four patients were available for postoperative follow-up. Of the 37 cases, 30 were transitional cell carcinoma (TCC), 4 squamous cell carcinoma, 1 ade nocarcinoma, and 2 undifferentiated carcinoma. Uterine involvement was obse rved in only 1 case: TCC, stage D1, grade IV. All patients had normal ovari es and a normal vagina regardless of tumor site or stage; however, late ova rian and vaginal recurrences developed in one patient, in whom one ovary ha d been preserved. Sixteen percent of the patients had urethral involvement. We conclude that synchronous or metachronous involvement of female interna l genitalia in bladder cancer is uncommon. Preservation of ovaries and vagi na in young patients undergoing radical cystectomy may be considered under strict criteria.