Introduction & Objectives The aim of this study is to report the experience of a high-volume center in the treatment of muscle-invasive bladder cancer on "genital sparing" radical cystectomy in female patients, evaluating oncological and functional (urinary and sexual) outcomes, at no less than 46 months follow-up. 

Materials & Methods The study was conducted retrospectively between January 2015 and January 2018. 8 female patients underwent radical cystectomy and bilateral pelvic lymphadenectomy with preservation of genital organs and orthotopic urinary neobladder. Inclusion criteria: recurrent T1G3 tumours, recurrent tumours after BCG therapy, T2 and T3a completely resected at endoscopic TURB. Exclusion criteria: T3b or higher bladder cancer, concomitant CIS and trigone and/or urethra involvement. 

Results Recurrence Free Survival and Overall Survival was 100%. 7/8 (87.5%) maintained complete continence during both day and night, and only 1 patient (12.5%) complained of urinary leakage during the night. The Sandvik Score showed a state of complete continence in 5 patients (62.5%); mild degree in 2 patients; moderate degree of incontinence in one patient (12.5%). One year after surgery the FSFI showed sexual desire in all patients (100%); subjective arousal, achievement of orgasm, sexual satisfaction in 7 / 8 patients (87.5%); sufficient lubrication in 6 / 8 patients (75%). Only one patient (12.5%) complained of dyspareunia during sexual intercourse. 

Conclusions “Genital sparing" cystectomy is a safe treatment from the point of view of oncological radicalism and it is advantageous in terms of urinary and sexual function, quality of life, psychological and emotional health of the patients.