NJ Bladder Cancer Treatment
Cystectomy is the procedure to remove all or part of the bladder. This is usually a procedure for patients with bladder cancer who have not had success with other treatments. There are two types of cystectomy, partial and radical.
Partial cystectomy is the removal of only part of the bladder. It is used to treat cancer that has invaded the bladder wall in just one area. Partial cystectomy is possible only if the cancer is not near the openings where urine enters or leaves the bladder. Radical cystectomy is the removal of the entire bladder, nearby lymph nodes, part of the urethra, and nearby organs that may contain cancer cells. In men, the prostate, seminal vesicles, and part of the vas deferens are also removed. In women the cervix, the uterus, the ovaries, the fallopian tubes, and part of the vagina are also removed.
This surgery can be performed as a laparoscopic surgery. This means that the doctor will only need to make a few, very small incisions. The doctor inserts a tube or scope with a light through the incisions, which allows the doctor to work through the incisions. The doctor will also create a new way for the urine to pass through your body during this surgery. One method of doing this is through an ileal conduit. The doctor will use a piece of your small intestine to make a tube that connects to your uterus to an opening the doctor makes in your belly. A plastic bag will attach to the tube coming out of your belly to serve as a passage for the urine to release into.
Another method of urine diversion is a continent reservoir. This uses a piece of your bowel to create a storage pouch that is attached inside your pelvis. There are two types of continent reservoirs, and both let you control when you want to urinate. The first type is a bladder substitution reservoir, also known as a neobladder. This is a possible option only if your urethra was not removed as part of the surgery, because the continent reservoir will attach to your ureters at one end and your urethra at the other. This allows you to pass urine as much as you did before surgery. The second type is a continent diversion reservoir with stoma, also known as a urostomy. This is the route to go if all or part of your urethra was removed during your surgery. Your continent reservoir will connect your ureters to an opening the doctor makes in your belly. You will pass a thin plastic tube called a catheter through the opening to release the urine.
After a cystectomy, patients usually are required to stay in the hospital for about a week. Patients usually experience discomfort the first week, but can be treated with medicine. Recovery is usually achievable within 6-8 weeks. Some patients require additional follow-up care and treatment after the cystectomy including radiation therapy, chemotherapy, or immunotherapy.
There are also many risks to consider before getting this procedure done. Short term complications such as acidosis, leakage of urine or stool, bowel obstruction, and kidney infection are common. Long term complications include obstruction of the ureters or intestines, kidney problems such as renal failure, problems with the newly created opening (stoma), and scar tissue formation inside the intestines. Patients may also experience trouble with sexual intercourse, and may also no longer be fertile after this surgery.
A cystectomy is a major surgery and requires a lot of consideration. Fortunately, it is highly effective in the treatment of bladder cancer. Your doctor will help you decide if this is the best treatment option for you based on the severity of your cancer. Schedule an appointment at Somerset Urological Associates to consult with an experienced professional. Call us today at 908-927-0300.