Radical cystectomy with fertility preservation for non-muscle invasive bladder cancer

Non-muscle invasive bladder cancer (NMIBC) includes stages Ta, T1 and CIS. Currently, NMIBC accounts for about 78% of newly diagnosed bladder cancer (BC). The main treatment method for NMIBC is transurethral resection of the bladder tumor (TUR) with early, single-dose adjuvant intravesical chemotherapy (CT). Subsequently, all patients are divided into prognostic factor risk groups. The main problem in treating patients is relapse of the disease; therefore, adjuvant therapy is recommended according to prognosis groups. In intermediate and high risk groups, relapse requires adjuvant intravesical therapy with maintenance courses. When pre-scribing the BCG vaccine, not all patients can complete the planned treatment due to adverse drug reactions, individual intoler-ance or refractoriness. In the EAU guidelines for NMIBC, the high-risk group has a subgroup of extremely high risk, in which radical cystectomy (RC) is indicated as the main treatment method. There are many publications on urine diversion and complications of surgical treatment. The question of performing RC with fertility preservation in patients with NMIBC remains relevant. This paper reviews previously published data on fertility preservation and oncological outcomes in patients included in the study. There are three main methods of fertility-preserving surgery: prostate-sparing, capsule-sparing and seminal vesicle-sparing cystectomy. The few studies on fertility preservation show heterogeneity in the groups of patients included in the study according to the stages of the disease and tumor grade. In this regard, ambiguous oncological results were obtained in the form of local relapse and pro-gression. Perhaps, after determining the criteria for indications for RC in patients with NMIBC with preservation of fertility, the treatment method will be performed more widely in a certain group of patients. © 2025 Elsevier B.V., All rights reserved.