Surgery is the standard treatment for bladder cancer. The types of surgical procedures used to treat bladder cancer depend on many factors including the invasiveness of the cancer at diagnosis. In 60-70 percent of patients, the cancer is confined to the surface layers of the bladder. For these patients with superficial bladder cancer, surgery is used to remove the cancer, leaving the bladder intact. However, when the cancer has invaded the muscle of the bladder, then the bladder must be surgically removed. Some patients may undergo partial bladder removal but these cases are rare.
Cystectomy: The surgery for bladder cancer is called cystectomy. For men with bladder cancer, the cystectomy removes the bladder, prostate, and lymph nodes. For women, the cystectomy removes the bladder, uterus, and in some cases part of the vaginal wall.
Bladder Reconstruction: For all patients who require removal of the bladder, reconstructive bladder surgery is done at the same time to create a new pathway or new bladder to restore urinary function.
Neobladder: This procedure uses a part of the small intestine to create a new bladder, which is connected to the ureters and urethra to allow urination in the usual way. Whereas the body's natural bladder works by expanding to hold urine and then contracting to pass urine, the neobladder is only able to expand. Over the course of several months after surgery, patients must learn how to tighten their muscles to help pass urine from the new bladder. Creation of a neobladder is highly complex and not possible for every patient. Patients who have undergone removal of the urinary sphincter muscle, cancer at the level of the urethra, radiation therapy to the pelvic area, or who have bowel problems are not eligible for this procedure.
Conduit: This procedure uses a part of the small intestine to create a tube from the ureters to the abdomen. The urine flows through this new tube directly into a urine bag worn on the outside of the patient's body.
Reservoir: This procedure uses a part of the small intestine to create a pouch inside the body that connects from the ureters to the area of the belly button or another part of the abdomen. The internal pouch collects the urine, and the patient is required to insert a catheter at skin level to drain the urine every four hours. This option is used only in select cases because patients must be vigilant in draining the urine regularly or the danger of an overfilled pouch may cause it to burst inside the patient.
Robotic Surgery
Cystectomy and bladder reconstruction surgery can be done using the traditional open approach or using robotic surgery. The Henry Ford Vattikuti Urology Insitute, as a national leader in robotic surgery, is one of few centers to regularly provide this advanced surgery for patients with bladder cancer.
Robotic surgery allows the most precise surgical motion, better than possible with traditional surgeries. This is critical in bladder cancer surgeries where removal of the bladder requires complex motions to avoid damage to nerves and the reconstruction of urinary function requires delicate sewing of the new pathway or new bladder. Robotic surgery for men with bladder cancer, as in robotic prostate surgery, helps to spare nerves to preserve sexual function. For all patients, robotic surgery helps to reduce blood loss during surgery, decreases pain and improves bowel function after surgery, shortens the hospital stay, and decreases overall complications by promoting faster healing and recovery.
The Henry Ford Vattikuti Urology Institute has partnered with the Urology and Nephrology Center in Mansoura, Egypt, which has one of the world's largest populations of bladder cancer because of the area's water parasites. Through this partnership of education, training, and research, the Henry Ford Vattikuti Urology Institute will continue to advance robotic surgery for patients with bladder cancer.
Surgery is the standard treatment for bladder cancer. The types of surgical procedures used to treat bladder cancer depend on many factors including the invasiveness of the cancer at diagnosis. In 60-70 percent of patients, the cancer is confined to the surface layers of the bladder. For these patients with superficial bladder cancer, surgery is used to remove the cancer, leaving the bladder intact. However, when the cancer has invaded the muscle of the bladder, then the bladder must be surgically removed. Some patients may undergo partial bladder removal but these cases are rare.
