Surgical Procedures for Bladder Cancer

Surgery is mainly used to treat bladder cancer. The goal is to remove the cancer and save how the bladder works. The impact on how the bladder works depends on the stage of cancer and which surgery is needed.

Earlier Stages of Bladder Cancer

Transurethral Resection

This type treats forms of bladder cancer that haven’t spread to deeper muscle. A transurethral resection (TUR) is done with a cystoscopy. A tube is passed through the urethra and into the bladder. The scope allows the doctor to see inside the bladder. Tools and lights can also be passed through the tube. Tumors are removed with a wire loop, chemicals, or by laser. Tissue samples are also taken so they can be looked at in a lab.

TUR can cure cancer in those with very early stage bladder cancer. Other treatments may still be needed.

It's common for bladder cancer to return, even after it's been treated. TUR may need to be repeated many times.

Cystectomy

If the cancer has spread beyond bladder surface and into the muscle, a cystectomy may be needed. A cystectomy is the removal of part or all of the bladder. Early stage bladder cancer may only require a partial cystectomy. This leaves a smaller, but still working bladder.

Bladder tissue is removed through a cut in the belly. The doctor may also take out nearby lymph nodes to see if cancer has spread.

Later Stages of Bladder Cancer

Radical Cystectomy

A radical cystectomy involves removing all the bladder and nearby lymph nodes. In men, the prostate gland is removed. In women, the ovaries, fallopian tubes, uterus, and a small part of the vagina may be removed with the bladder. Cystectomy may offer a cure for some types of bladder cancer. But, some may need more treatment.

Since the bladder is removed, there is no way to store or pass urine from the body. A urinary diversion will allow the urine to leave the body. The types are:

  • Conduit diversion —The ureter will be linked to a section of the small intestine. This is so urine can drain into the intestine. It’s then linked to an opening in the belly wall. This is called a stoma. Wastes pass into a bag outside of the body.
  • Continent diversion —The ureters are linked to a pouch made from the intestines. It’s then linked to a stoma. Wastes can pass into a bag outside of the body.
  • Neo-bladder —This method saves some of the working bladder. A pouch is made using the intestines. Both the ureters and urethra are linked to this pouch. This way urine can pass out of the body. Sometimes, a tube is used. This type can also be done if the cancer is blocking urine flow and a cystectomy is not possible.
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References:

Bladder cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115106/Bladder-cancer. Updated June 26, 2018. Accessed August 3, 2018.
Bladder cancer. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/bladder-cancer. Updated October 2017. Accessed August 3, 2018.
Bladder cancer surgery. American Cancer Society website. Available at: https://www.cancer.org/cancer/bladder-cancer/treating/surgery.html. Updated May 23, 2016. Accessed August 3, 2018.
Cystectomy. Encyclopedia of Surgery website. Available at:
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Accessed August 3, 2018.
Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq. Updated May 3, 2018. Accessed August 3, 2018.
Last reviewed June 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 8/3/2018

 

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