Surgery is a common method of diagnosing and treating bladder cancers.
A transurethral resection of bladder tumor (TURBT) issued to determine if someone has bladder cancer. This procedure is typically performed under a general anesthetic and involves utilizing an electric loop that is passed into the bladder of the scope to remove bladder tumor tissue. In addition to removing as much tumor as possible tumor within the bladder, it also allows proper characterization of the tumor grade and stage. Occasionally, chemotherapy is inserted into the bladder at the end of TURBT to reduce risk of recurrent tumor.
When bladder cancer is invading the muscle or is not successfully treated with BCG the bladder may need to be removed. This operation is called a radical cystectomy. The surgeon removes the entire bladder and surrounding lymph nodes in order to keep the cancer from spreading to other organs and tissues. In men, the prostate is also removed. In women, the uterus, fallopian tubes, ovaries, and part of the vagina may also be removed along with the bladder.
During this surgery, surgeons must also reconstruct the urinary tract to allow urinary drainage. The two most common methods of urinary diversion are creation of an ileal conduit and creation of orthotopic neobladder. Both of these reconstructions use portions of the patient’s intestines. With ileal conduit, a stoma is created on the abdomen to allow urine to continuously drain into an external appliance attached to the abdomen. Orthotopic neobladder involves creation of a pouch (neobladder) that is connected to the urethra so urine passes out of the body through the uretha. In certain situations, a continent cutaneous reservoir may be an option in select patients. This allows drainage of urine by passing a catheter through an opening created on the abdomen.