I suspect that "nerve-sparing," if it is possible in your situation, would be helpful if it is successful. This is a subject to discuss frankly with your urologist/surgeon and, if possible, get a second opinion at a place that deals with a lot of situations such as yours.
The President of our American Bladder Cancer Society, Cynthia, also tried the "bladder-sparing" route with chemo and radiation and it failed also. By then her bladder was in such bad shape (the residents in her initial hospital referred to it, when they thought she couldn't hear them, as a "crispy critter") that it was necessary for her to travel elsewhere to find someone qualified to deal with removal of her very damaged bladder and construction of a suitable diversion.
You need to have a long discussion with your surgeon, as I suggested above, about all your concerns, including the type of diversion he will be able to do because of the damage to your bladder.
Please let us know what you discover as you go along since there are others who read this who will want to know.
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Upon diagnosis of bladder cancer in 2017 I refused immediate organ removal prompted by surgeon. Opted for organ sparing approach with chemo first and then 47 radiation treatments. It bought me about two years. Just had a third tumor removed and urologist says the bladder was practically destroyed by the radiation and must go. And along with it must go my prostate. This last is the most upsetting to me. I have had a very active sex life and without that outlet I fear depression will bring me down to a dangerous state. My question: Does NERVE-SPARING surgery on the prostate bladder offer better chances of a sex life thereafter or is "nerve sparing" just a catch-phrase?