Bladder Cancer Surgery

A ureteral stent is a long, soft tube that stretches from the kidney to the bladder. You have probably heard about cardiac stents for people who have clogged arteries. These stents hold the arteries open so blood can continue to flow to the heart. Ureteral stents are similar in that they allow the urine to [...]

The immediate surgical risks of a partial cystectomy are similar to the risks for a radical cystectomy. These include bleeding, infection, damage to adjacent organs, and so forth (see Question 39). During a radical cystectomy, the bladder is removed intact. For a partial cystectomy, the bladder is opened, which potentially exposes the body to a [...]

To be eligible for a partial cystectomy, the tumor must be just in the right place and just the right size. Tumors at the dome (top) of the bladder are the most amenable to partial cystectomy. Many patients without cancer develop outpouchings in their bladder called a diverticulum. These outpouchings have no muscle on them, [...]

A partial cystectomy is the removal of only that part of the bladder that has cancer in it. It essentially takes the place of the TURBT in other bladder-sparing protocols. It potentially improves the removal of the tumor over TURBT and gives the pathologist a better ability to identify the tumor and its limits correctly [...]

A continent urinary diversion provides a reservoir for the urine that can be drained every few hours by a catheter inserted by the patient. A segment of bowel is used to create a pouch inside the abdomen into which the urine drains. A small channel is then created that connects the pouch to the abdominal [...]

Long-term problems after an ileal conduit are not uncommon. Overall, up to two thirds of patients will experience some type of problem. These problems can be categorized as follows. Stoma: About one in four patients will have a problem related to their stoma. The most frequent problems are parastomal hernias (a weakening of the tissues [...]

Having a bag on your abdomen will not prevent you from doing the things that you used to do before surgery. The bag is pretty secure when snapped onto the wafer properly. Some individuals who are very active may use a strap or something of that nature to lightly press the bag against the skin [...]

Removal of the entire bladder, radical cystectomy, is the gold standard treatment for invasive bladder cancer. Rarely, individuals may be candidates for less invasive surgery or bladder-sparing regimens. Historically, the primary option to divert the urine after a radical cystectomy was an ileal conduit . Over the years, a variety of continent urinary diversions and [...]

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 [...]