The advantages of a neobladder over a urostomy or continent diversion are primarily lifestyle related and cosmetic. A neobladder is an attempt to replace the bladder with as close to a normal bladder, and therefore lifestyle, as possible. In an ideal situation, the neobladder will function like a normal bladder, storing urine at low pressure [...]

A neobladder is one of the options for reconstruction of the urinary tract after surgery. Other options include an ileal conduit or a continent cutaneous diversion. A neobladder is an attempt to replace the normal bladder as closely as possible with other tissues. A long segment of small bowel is isolated during surgery and fashioned [...]

The most important part of the decision-making process is to talk with your urologist openly about your concerns. The two of you should decide together which option is best given any other medical problems, lifestyle, manual dexterity, and mobility, as well as the specifics of your tumor. A neobladder is often recommended for younger, healthier [...]

This is an important question. Obviously, your body still needs to make urine. It would be ideal to replace your bladder with an artificial or synthetic bladder. Unfortunately, no one has found a man-made material that can be exposed to urine without stones forming on it. Any nonabsorbable synthetic material in contact with urine will [...]

More attention has been focused on the effects of surgery on male sexual dysfunction than has been focused on female sexual dysfunction. Surprisingly, it is only in recent years that any attention has been focused here. In women, a radical cystectomy typically includes removal of the uterus (hysterectomy), ovaries, and fallopian tubes (salpingooophorectomy), and a [...]

In males, in addition to removal of the bladder, the procedure includes removal of the prostate and seminal vesicles. The portion of the procedure involving the prostate and seminal vesicles is essentially identical to that per-formed during a radical prostatectomy for prostate cancer. Thus, you share the same risks of erectile dysfunction after surgery as [...]

Radical cystectomy with the creation of a urinary diversion is a major surgical procedure. It takes several hours to perform the procedure and includes operating on the intestines. The recovery from this surgery can be expected to take much longer than shorter or less complicated procedures. Immediately after surgery on the intestines, their function is [...]

In most cases, pelvic lymph node dissection does not increase the morbidity of a radical cystectomy operation. This means that people who have a radical cystectomy with a pelvic lymph node dissection have the same out-comes from surgery as do those patients without the pelvic lymph node dissection. Rarely, a patient may develop a lymphocele. [...]

A pelvic lymph node dissection is a procedure that removes those lymph nodes that are most likely to harbor metastatic bladder cancer. The lymphatic sys-tem collects fluid throughout the body and returns it to the bloodstream through its own set of tiny channels. Cancer cells often escape the bladder through these channels and establish sites [...]

A radical cystectomy is major surgery and as such has serious potential risks. Keep in mind, however, that the goal of surgery is to cure you of cancer. As such, minor complications are not uncommon, and major complications are possible. Up to one third of all patients will have at least one complication early on. [...]

I am an older person and am afraid that major surgery will be too much for me. Do older people do well after a cystectomy? This is a valid concern and one that many physicians share. How old is too old? The answer here is encouraging. Two studies have looked at radical cystectomies performed in [...]

Yes. The caution here is that radiation to the abdomen or pelvis (i.e., for ovarian cancer, prostate cancer, lymphoma, or other cancer) makes the procedure more difficult for the surgeon and increases the risks for the patient. Radiation causes the tissues to become very stuck together. In this situation, normal dissection during surgery is not [...]

Robotic surgery is essentially an outgrowth of laparoscopy. Laparoscopy can be difficult because the instruments need to be long and straight to be inserted through the skin. It can thus be difficult to reach some areas and to manipulate the tissues appropriately (imagine trying to sew with chopsticks). Robotic surgery attempts to overcome these limitations. [...]

Absolutely. It can be done. Multiple surgeons have now reported that they have performed the procedure successfully. In women, the procedure technically is similar to removal of the uterus, a procedure that is commonly performed laparoscopically. In men, the procedure is complicated by the presence of the prostate attached to the bladder. Laparoscopic removal of [...]

Laparoscopy refers to surgery that is done by using instruments inserted into the body through a tiny incision. A camera attached to a small telescope inserted through another tiny incision provides visualization for the surgeon. This is one technique in a field that is now called minimally invasive surgery, or surgery that seeks to minimize [...]

Or Do I Need To Travel To A Large Referral Center? Many local hospitals across the country provide excel-lent care that is convenient for both you and your family. Several factors are involved in making this decision, but in the end, most patients make this type of decision based on (1) family support and (2) [...]

Studies have generally shown a slight advantage to getting chemotherapy before undergoing surgery. When these studies are combined, we are able to see about a 5% improvement in overall survival at five years. One important point to make about preoperative chemotherapy is that it delays surgery by several weeks while the patient receives treatment. Not [...]

Radical cystectomy is the procedure of choice for many different types of patients. Most commonly, it is per-formed in patients who have muscle-invasive bladder cancer. If a bladder cancer invades the muscle, then other treatments such as TURBT and BCG are unlikely to fully treat the cancer, putting you at risk for metastases. Although invasive [...]

A radical cystectomy is the complete surgical removal of the bladder. It can be thought of as three separate procedures: (1) removal of the bladder, (2) removal of the lymph nodes, and (3) creation of a bladder substitute. When performed for bladder cancer in men, it usually includes removal of the prostate, seminal vesicles, and [...]

Bladder cancer surveillance refers to the period of time that you are monitored for a recurrence of bladder cancer after the bladder cancer has been removed or treated. It is a term that is used for patients who have been treated for superficial bladder cancer. Even after successful treatment of a tumor, it is important [...]