Bladder Cancer Surgery
Surgery is the most common treatment for bladder cancer. It treats the cancer by focusing only on the bladder and the areas close to the tumor.
Surgical treatment of bladder cancer includes 2 methods:
TURBT - Transurethral Resection of Bladder Tumors
A procedure in which cancer cells are removed using a loop that cuts then cauterizes. This treatment procedure is used if the cancer is growing slowly and is restricted to the bladder lining. During TURBT, a cystoscope is inserted into the bladder through the urethra. The doctor uses a cutting tool contained in the cystoscope to remove the tumor. If necessary, the doctor may use an electric current to burn away remaining cancer cells (referred to as fulguration). The doctor may also take biopsies of both the tumor and surrounding normal cells. These samples will be sent to the laboratory for examination. A TURBT is usually performed under general or spinal anesthesia. Most people go home the same day as the procedure but if the tumor is large, the surgery may take longer than usual and you may remain in the hospital overnight.
Cystectomy
A procedure that involves partial or total removal of the bladder. If the bladder is removed, additional surgical procedures will be performed to make a new pathway for urine. A cystectomy, or surgical removal of the bladder, is the best option for aggressive bladder cancers. The procedure involves a careful examination of all the organs and tissue in the area of the bladder to make certain that cancer has not spread outside the bladder. Your doctor may remove the lymph nodes in the region. Because there is a significant risk that the cancer may return following cystectomy, your doctor will arrange for frequent follow-up appointments. A radical cystectomy includes 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 prostate gland also will be removed; sometimes, the urethra may be removed as well.
In women, the lower end of the ureters, the front wall of the vagina, the uterus, the Fallopian tubes, and the ovaries also will be removed. Please speak to your doctor if you are would like to keep your ovaries. In both men and women, the nerves in the pelvic area may be damaged, which can affect sexual performance. Should sexual problems occur, your doctor will discuss with you the medical and surgical ways of addressing such difficulties. In some instances, a segmental (or partial) cystectomy is performed where only the cancer and some of the bladder tissue around the tumor are removed. A pathologist will examine the tissue removed during the procedure to check for the presence of cancer cells.
Robot-assisted Cystectomy
Since 2005, Roswell Park has a minimally invasive option for surgical bladder removal called robot-assisted radical cystectomy. The robotic surgical equipment imitates the movements of a human surgeon’s hands while increasing precision. The procedure is done laparoscopically — that is, through small incisions in the abdomen — rather than by using the traditional, open, large incision. Compared to traditional cystectomy, robot-assisted radical cystectomy involves a 50% decrease in pain, less blood loss, quicker recovery, and fewer complications.
