Endoscopic TUR surgery for patients with early-stage bladder tumors is considered a relatively simple operation and can be performed with spinal anesthesia (regionel).
However, radical cystectomy surgery that we perform in advanced bladder cancers is one of the major surgeries of urology and is a challenging operation that can take up to 4-5 hours.
Since the operations that require removal of the bladder are long-term surgeries, metabolic problems, respiratory, circulatory and intestinal problems may occur in the postoperative period, since an intestinal segment will be required to create a new bladder and to create a reservoir for the abdomen after the bladder is removed. These disruptions are minimized by experienced centers.
Since it is a major surgery, there is a risk of major complications and death, but this risk is much lower than leaving the disease untreated. Endoscopic surgeries performed in low-stage bladder cancer can be considered as low-risk surgeries.
The main treatment for bladder cancer is surgery. Therefore, the only treatment method for bladder tumor that has not spread to distant organs is surgery.
After the diagnosis of bladder cancer, it is necessary to remove the bladder, especially in patients who are found to have spread to muscle tissue. It is quite natural for these patients to look for how they will continue their lives after the bladder is removed and how those who have this surgery feel. Consult your doctor for the comments of patients who have had this surgery.
Complete recovery is possible in non-metastasized advanced stage (T2) bladder cancer, especially in low- and intermediate-stage bladder cancers (Ta, T1).
After endoscopic TUR operations for low and moderate bladder tumor surgery, there is almost no possibility of deterioration of sexual functions in both male and female patients. It is also okay for these patients to have sexual intercourse after surgery.
No. Bladder cancer is not a sexually transmitted disease, but smoking and environmental toxins are the most important factors.
Bladder cancer may first spread to regional lymph nodes, distant lymph nodes, bones, lung, liver and urinary tract and inner surface epithelium of the kidney.
While endoscopic, TUR-BT surgeries for low-stage (Ta, T1) bladder cancer take 30-120 minutes, radical cystectomy surgery performed in stages requiring removal of the bladder (T2, T3) takes 4-5 hours on average.
Bladder cancer surgery varies according to the stage of the tumor. First, when the diagnosis of the disease is made by imaging methods such as ultrasonography, tomography or cystoscopy, tumors are removed by endoscopic method (TUR surgery).
If the entire tumor can be removed with this endoscopic surgery and the tumor has not spread to the muscle tissue of the bladder in the pathological evaluation, this surgery will usually be sufficient and the patient will be followed up with various algorithms later on.
However, if it is shown that the cancer has progressed to the muscle tissue in pathological specimens resected by TUR surgery, the entire bladder should be removed. This surgery is called radical cystectomy.
In advanced bladder cancer surgery, prostate, semen and regional lymph nodes are also removed along with the bladder in male gender. In the female gender, the uterus, ovaries, 1/3 inner part of the vagina and regional lymph nodes are taken together with the bladder.
The price of bladder cancer surgery varies according to the stage of the cancer, the experience of the surgeon, and the hospital conditions. Costs range 7000-12000 USD for radical cystectomy and 2000-4000 USD for endoscopic treatment in Turkey.
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One of the questions on the minds of bladder cancer patients is how they will urinate if the bladder is removed. When performing bladder removal surgery (radical cystectomy) in advanced bladder cancer, the urinary canals (ureters) that transmit the urine produced from the kidneys downwards are transferred to another place, and urine output is provided for the rest of life.
This process can be performed in several ways. Bagless life is possible (neobladder) by making a new bladder with a piece taken from the intestines instead of the removed bladder and placing it in the same anatomical region.
Another frequently used method is to take a short piece of the intestine and connect the ureters to an applied reservoir, and attach a bag (ileostomy) so that the other part is opened to the lower part of the abdomen. Another method is to open the ureters directly to the abdominal skin and attach a bag (ureterocutaneous ostomy). These are roughly the three most commonly used methods.
Individuals whose bladder is removed do not experience problems in maintaining their normal lives. The cosmetic problems of individuals who have a bag on their abdomen do not affect their normal lives.
In these patients, which we mentioned above, the abdomen is puched and the urine output is provided with a bag attached to the abdomen. In some suitable patients, connection to the normal urinary tract (penis in men, above the vagina in women) can be achieved with the new bladder formed from the intestine.
After the bladder is removed, the urine flowing from the urinary tract, which is mouthed to the abdomen, is collected with a urostomy bag. Patients worry about changing the bag in their new life. These patients are trained for bag change and they adapt easily to bag change.
Partial or complete erection problems may be experienced in male patients whose bladder is removed due to bladder cancer. This depends on the stage of the disease and the age of the patient. In female patients, they can continue their sexual life as a part of the vagina is protected.
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Assoc. Prof. Dr. Arif Demirbaş
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04.04.2023On 03/07/2023, Doruk Hospital urology doctor Assoc. Dr. I had a successful prostate surgery performed by Arif Demişrbaş. I would like to thank him and his team for their close attention both be{...}
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