Bladder cancer surgery
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Steven C. Campbell, M.D., Ph.D.
Overview
Surgery is a common treatment for bladder cancer. The type of surgery depends largely on the stage and grade of the tumor.
Surgery
Different type of surgery and discuss which is most suitable for the patient:
- Transurethral resection: Early (superficial) bladder cancer is treated with transurethral resection (TUR). During TUR, the doctor inserts a cystoscope into the bladder through the urethra. The doctor then uses a tool with a small wire loop on the end to remove the cancer and to burn away any remaining cancer cells with an electric current. (This is called fulguration.) The patient may need to be in the hospital and may need anesthesia. After TUR, patients may also have chemotherapy or biological therapy.
- Radical cystectomy: For invasive bladder cancer, the most common type of surgery is radical cystectomy. This type of surgery is choosen when superficial cancer involves a large part of the bladder. Radical cystectomy is the removal of the entire bladder, the nearby lymph nodes, part of the urethra, and the nearby organs that may contain cancer cells. In men, the nearby organs that are removed are the prostate, seminal vesicles, and part of the vas deferens. In women, the uterus, ovaries, fallopian tubes, and part of the vagina are removed.
- Segmental cystectomy: In some cases, the doctor may remove only part of the bladder in a procedure called segmental cystectomy. This type of surgery is chosen when a patient has a low-grade cancer that has invaded the bladder wall in just one area.
Sometimes, when the cancer has spread outside the bladder and cannot be completely removed, the surgeon removes the bladder but does not try to get rid of all the cancer. Or, the surgeon does not remove the bladder but makes another way for urine to leave the body. The goal of the surgery may be to relieve urinary blockage or other symptoms caused by the cancer.