Bladder cancer surgery is a critical component of the treatment process for individuals diagnosed with this disease. Understanding the various types of surgeries, what to expect during the procedure, and the recovery process can empower patients and their families to make informed decisions.

There are several types of surgeries for bladder cancer, with the most common being transurethral resection of bladder tumor (TURBT), cystectomy, and urinary diversion.

Transurethral Resection of Bladder Tumor (TURBT)

TURBT is often the first step in treating bladder cancer, especially for non-invasive tumors. During this procedure, a surgeon uses a cystoscope to remove tumor tissue from the bladder wall. This outpatient procedure typically takes about an hour, and most patients can go home the same day.

The main goal of TURBT is to diagnose the cancer and determine its stage. It can also relieve symptoms like bleeding or obstruction. However, it may not be sufficient for invasive tumors, which could require further treatments.

Cystectomy

For cases where cancer has invaded the bladder wall or is recurrent, cystectomy may be necessary. This surgical procedure involves removing part or all of the bladder, depending on the extent of the cancer.

There are two types of cystectomy: partial cystectomy, where only the cancerous part of the bladder is removed, and radical cystectomy, which entails removing the entire bladder along with surrounding tissues and possibly nearby lymph nodes.

Post-surgery, patients will need to adapt to changes in urinary function, and reconstructive options such as a neobladder or ileal conduit can be discussed with the surgical team.

Urinary Diversion

After a cystectomy, patients will need a new way to store and eliminate urine. Urinary diversion refers to the methods used for this purpose. The three primary forms are:

• Neobladder: The surgeon creates a new bladder from a section of the intestine, allowing patients to potentially eliminate urine in a more natural manner.
• Ileal conduit: A piece of the intestine is used to create a conduit for urine to pass from the kidneys to an external bag attached to the abdomen.
• Continent urinary reservoir: This method involves creating a pouch from intestinal tissue that allows for controlled urination through a catheter.

Preparing for Bladder Cancer Surgery

Preparation for bladder cancer surgery involves several steps, including a thorough evaluation by the healthcare team. Patients should discuss their medical history, any medications they are taking, and any allergies they may have.

It is crucial for patients to follow pre-operative instructions, which may include dietary restrictions and guidelines for medication adjustments. Arranging transportation and support for the recovery period is also essential.

Recovery and Aftercare

The recovery process varies depending on the type of surgery performed. TURBT typically has a shorter recovery time compared to cystectomy. Patients may experience pain, urinary changes, or bleeding, all of which should be monitored. Following the surgeon's aftercare instructions is vital for healing.

Regular follow-up appointments will be scheduled to monitor recovery, assess for signs of recurrence, and provide additional treatments if necessary.

Bladder cancer surgery can be intimidating, but understanding the processes involved and what to expect can make a significant difference. With proper preparation and support, patients can navigate this challenging journey more confidently.