Surgery for Bladder Cancer

The TURBT is the most conservative surgery for bladder cancer. Still, it has some side effects including possible bleeding and infection, perforation of the bladder, and blocked ureters.

Transurethral resection generally takes place in the hospital with the patient under general anesthesia. The doctor inserts a cystoscope, a small, lit camera, in through the urethra and into the bladder. A small tool with a wire loop at the end is inserted through the cystoscope. A high-frequency electric current passes through the wire tool removing and burning cancer cells. This method is called fulguration. In some situations, fulguration will not be enough to eradicate the tumor.A radical cystectomy consists of the surgical removal of the bladder as well as the tissue and some of the organs around it. For men, the prostate and the seminal vesicles, and possibly the urethra, are often removed. For women, the uterus, ovaries, fallopian tubes, part of the vagina, and the urethra are often removed. A pelvic lymph node dissection, removal of the lymph nodes in the pelvis, may also be performed to determine whether the cancer has spread to these lymph nodes. Pelvic lymph node dissection adds little to the overall side effects of radical cystectomy, improves staging accuracy and may be curative in some patients with minimal lymph node involvement.Cystectomy. This procedure removes the bladder and is useful in cases that involve more widespread bladder cancer. If you are having a partial cystectomy, only part of your bladder is to be removed. Partial cystectomy is usually done when the cancer is in only one small part of the bladder.A urostomy (or ileal conduit) is the most common operation and it means your urine will be collected in a bag. During the operation the surgeon removes a section of your small bowel and joins the two ureters to one end of it. They bring the other open end of the bowel out through the skin of your abdomen.

The ureters carry urine from your kidneys to the piece of bowel. The piece of small bowel (ileum) acts as a channel (conduit) to take the urine to the surface of the abdomen. This is why this operation is sometimes called an ileal conduit. The small hole on the surface of the abdomen, through which the urine now passes out of the body, is called a stoma.