Bladder Cancer Surgery
In some cases, the doctor may remove only part of the bladder in a procedure called segmental cystectomy. The doctor chooses this type of surgery when a patient has a low-grade cancer that has invaded the bladder wall in just one area.
Other Considerations for Bladder Cancer SurgerySometimes, when the cancer has spread outside the bladder and cannot be completely removed, the surgeon will remove the bladder but will not try to get rid of all the cancer. Or, the surgeon will not remove the bladder but will make another way for urine to leave the body (urinary diversion). The goal of the surgery may be to relieve urinary blockage or other symptoms that are caused by bladder cancer.
Adjuvant TherapyEven if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy after surgery to kill any cancer cells that remain. Bladder cancer treatment that is administered after surgery, to increase the chances of a cure, is called adjuvant therapy.
Recovering From SurgeryFor a few days after TUR, patients may have some blood in their urine and difficulty or pain when urinating. Otherwise, TUR generally causes few problems.
After a cystectomy, most patients are uncomfortable, tired, and weak. However, medicine can control the pain, and patients should feel free to discuss pain relief with their doctor or nurse. The length of time it takes to recover from an operation varies for each person.
After a segmental cystectomy, patients may not be able to hold as much urine in their bladder as they used to, which means that they may need to urinate more often. In most cases, this problem is temporary, but some patients may have long-lasting changes in how much urine they can hold.
If the surgeon removes the bladder, the patient will need a new way to store and pass urine. The most common method is to use a piece of the person's small intestine to form a new tube through which urine can pass. The surgeon will attach one end of the tube to the ureters and connect the other end to a new opening in the wall of the abdomen. This opening is called a stoma. A flat bag fits over the stoma to collect urine, and a special adhesive holds it in place. The operation to create the stoma is called a urostomy or an ostomy.
For some patients, the doctor is able to use a part of the small intestine to make a storage pouch (called a continent reservoir) inside the body. In this procedure, urine collects in the pouch instead of going into a bag. The surgeon connects the pouch to the urethra or to a stoma. If the surgeon connects the pouch to a stoma, the patient will use a catheter to drain the urine.