Objective To report the perioperative outcomes and short-term efficacy of posterior capsule of prostatic apex sparing laparoscopic radical cystectomy and intracorporeal orthotopic neobladder (PCPAS-LRC-ICONB), also known as the Studer technique.

Methods A retrospective analysis was conducted on 34 male patients who underwent PCPAS-LRC-ICONB between July 2019 and July 2023 at Huai’an Hospital of Huai’an City and Tianjin Medical University Second Hospital. The perioperative and short-term outcomes of PCPAS-LRC-ICONB were summarized.

Results All 34 patients completed the PCPAS-LRC-ICONB procedure successfully. Neobladder-urethral anastomosis was performed without tension, and no cases required conversion to open surgery. The median operative time was 420 min (range 350–520 min), with a median estimated blood loss of 200 mL (range 150–600 mL). The median follow-up time was 22.5 months (range 4–60 months). No complications of Clavien grade three or higher occurred during the perioperative period. At 12 months postoperatively, the daytime and nighttime urinary continence rates were 88.9% and 66.7%, respectively. All the patients were satisfied with their urinary continence status. The median bladder capacity was 225 mL (range 100–400 mL) and the median residual urine volume was 20 mL (range 0–50 mL). Pulmonary metastases were detected in two patients at 6 and 15 months postoperatively, bone metastases in two patients at 18 and 25 months, liver metastasis in one patient, and local recurrence (one case of abdominal wall implantation) in two patients. By the end of the follow-up period, one patient died from cerebral infarction, one from myocardial infarction, one from other accidents, and six patients died from bladder cancer recurrence and/or metastasis.

Conclusions PCPAS-LRC-ICONB reduced the difficulty of neobladder-urethral anastomosis, and the perioperative and short-term outcomes were satisfactory.