Background/Objectives: Radical cystectomy (RC) is the standard treatment for muscle-invasive and high-risk non-muscle-invasive bladder cancer, but it often results in significant functional impairments, including sexual and urinary dysfunction, adversely affecting quality of life (QoL). Sexual-sparing robotic-assisted radical cystectomy (RARC) has been introduced to mitigate these effects. This review evaluates the oncological and functional outcomes of sexual-sparing RARC in male and female patients.Methods: A systematic literature search identified 15 studies including 793 patients who underwent sexual-sparing RARC using techniques such as nerve-sparing, capsule-sparing, and pelvic organ-preserving approaches. Data on oncological and functional outcomes were analyzed.Results: Sexual-sparing RARC achieves oncological outcomes comparable to open RC, with negative surgical margin (NSM) rates exceeding 95% in most studies. RFS and CSS rates were robust, often surpassing 85% at intermediate follow-ups. Functional outcomes were also favorable, with continence rates exceeding 90% and erectile function recovery surpassing 70% in well-selected male patients. Female patients undergoing pelvic organ-preserving techniques demonstrated improved continence, preserved sexual function, and enhanced QoL. Patient selection emerged as critical, favoring those with organ-confined disease and good baseline function.Conclusions: Sexual-sparing RARC offers a promising balance between oncological control and functional preservation, making it an effective option for selected patients. Further research is needed to refine techniques and establish standardized protocols for broader adoption.
**背景/目的：** 根治性膀胱切除术是治疗肌层浸润性和高危非肌层浸润性膀胱癌的标准方法，但常导致显著的功能损害，包括性功能和排尿功能障碍，对生活质量产生负面影响。为减轻这些影响，性功能保留的机器人辅助根治性膀胱切除术已被引入。本综述旨在评估男性和女性患者接受性功能保留机器人辅助根治性膀胱切除术的肿瘤学和功能学结果。 **方法：** 通过系统性文献检索，共纳入15项研究，涉及793例接受性功能保留机器人辅助根治性膀胱切除术的患者，手术技术包括神经保留、包膜保留及盆腔器官保留等。对肿瘤学和功能学结果数据进行了分析。 **结果：** 性功能保留机器人辅助根治性膀胱切除术的肿瘤学结果与开放根治性膀胱切除术相当，多数研究中手术切缘阴性率超过95%。无复发生存率和癌症特异性生存率表现稳健，在中位随访期内常超过85%。功能学结果亦良好，在严格筛选的男性患者中，尿控率超过90%，勃起功能恢复率超过70%。接受盆腔器官保留技术的女性患者则表现出尿控改善、性功能保留及生活质量提高。患者选择至关重要，更适用于器官局限性病变且基线功能良好的患者。 **结论：** 性功能保留机器人辅助根治性膀胱切除术在肿瘤控制与功能保留之间实现了良好的平衡，是特定患者的有效选择。未来需要进一步研究以优化技术并建立标准化方案，促进其更广泛的应用。
肿瘤(癌症)患者之家