Bladder Cancer

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Surgery

Urological surgery is done to remove cancerous tissue from the body and is essential for diagnosing bladder cancer and determining the extent, or stage, of the cancer. Surgery is the primary treatment for noninvasive bladder cancers. It is also an important option for treatment of invasive bladder cancer. This page describes the most common bladder cancer surgeries.

Cystoscopy

The doctor uses a cystoscope (a thin camera inserted through the urethra) to examine the bladder and identify possible cancer lesions. The cystoscope can also be used to remove a tissue sample (biopsy) to help determine the type and stage of the cancer.

Transurethral Resection of Bladder Tumor

For this procedure, also known as TUR or TURBT, the doctor inserts a special cystoscope called a resectoscope into the bladder through the urethra. Then the doctor uses a special wire loop to remove the cancer cells from the bladder tissue. The goal of this procedure is to remove (resect) as much of the tumor as can be done safely. This is the most common primary treatment for superficial bladder cancer and is required for diagnosis of all bladder tumors.

Radical Cystectomy

This surgical procedure is used when the cancer is found to have invaded the bladder muscle. 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 are typically removed. 

To provide for drainage of urine, surgeons must reconstruct a drainage system. There are three options for urinary reconstruction, all using portions of the patient’s intestines that have been separated from the rest of the intestines: 

  • Ileal conduit/loop: With the ileal conduit, an opening (stoma) in the abdomen so urine can continuously drains to an external appliance attached outside the abdomen.
  • Continent cutaneous urinary reservoir (CUR): The CUR is a storage system that the patient drains every few hours using a catheter inserted through a opening on the abdomen.
  • Orthotopic neobladder: This involves reconstructing a bladder. SCCA physicians have pioneered techniques for doing this. A neobladder is a “new bladder” made from a section of the bowel. It is connected to the urethra so that patients can urinate as they did before surgery.