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Surgical Management of Bladder Cancer: An Overview

 Surgery is the first preferred treatment for bladder cancer, especially when the cancer has been diagnosed and has not spread. With the help of a surgery, the cancerous tumor of the bladder is removed, making the functioning of the bladder normal. There are several procedures that may be performed depending on the bladder’s stage, including transurethral resection for small tumors and removal of the bladder (cystectomy) for larger tumors.






In this blog Dr. Niren Rao, a leading urologist at Delhi Urology Hospital will explain the different procedures performed for bladder cancer. Keep reading to learn more types of Bladder Cancer Surgery in Delhi


Treatment Options for Bladder Cancer 


A urologist treats bladder cancer by performing the below surgeries: 


1. Transurethral Resection of Bladder Tumor (TURBT): In this non-invasive procedure, the expert urologist inserts a scope (tube) inside the urethra. The tube has a thin wire loop at one end to remove the small cancerous cells from the bladder. This surgery is done for patients diagnosed with bladder tumors, and no cuts are involved in this surgery. 


How is TURBT Performed? 


  • The surgery is performed under general anesthesia. In case of small tumors, spinal anesthesia can also be used by administering a small injection in the back, which numbs the body beneath the umbilicus. 

  • Patients are advised to lie down in the lithotomy position, and with the help of a telescope, the surgeon introduces a thin tube, also called a resectoscope, into the bladder. 

  • The complete bladder is inspected, and the small tumors are cut out and sent for biopsy. After removing the tumor, a part of the bladder wall is also resected and sent for biopsy to analyze how deep the tumor was. In the case of large tumors, small tissue is sent for biopsy, or the surgery is performed in stages. 

  • Intravesical chemotherapy is administered at the end of the procedure in the case of small tumors to treat any microscopic cancer cells that cannot be removed by surgery.

  • A catheter is inserted into the bladder at the end of the surgery to help drain the bladder and irrigate any remaining blood or clots. For more information about TURBT surgery, pay a visit to Delhi Urology Hospital, a leading Urology Hospital in Delhi


2. Partial Cystectomy: This procedure is known as "bladder preservation surgery." It entails removing only a portion of the bladder. It is only performed in certain circumstances, such as when the tumor is small or simple to access, if it has not spread, or if it has only invaded the muscular layer of the bladder in one location. Reconstructive surgery is unnecessary as most of the bladder remains, but additional surgery might be required to restore function completely. Patients are asked to stay in the hospital for 2-3 days, and the urinary catheter is kept for three weeks.


3. Radical Cystectomy: This procedure involves removing the complete bladder, local lymph nodes, as well as some other tissues, such as the layer of fat surrounding the bladder. It is used for most tumors that have spread to the muscle layer of the bladder (stage 2 and stage 3 cancers). The prostate, seminal vesicles, and a portion of the urethra may be removed for individuals with male anatomy. The uterus, fallopian tubes, sometimes the ovaries and a portion of the vagina may also be removed in individuals with female anatomy.


Why is Urinary Diversion Done During and After Bladder Cancer Treatment? 


A urinary diversion can be performed for the following reasons:


  • For bladder cancer, when the whole bladder gets removed (called a radical cystectomy)

  • To relieve the blocked urine flow

  • After pelvic exenteration surgery for treating some advanced cancers

  • If there is damage caused to the bladder from radiation therapy or any other cancers

  • For other reasons, such as urinary tract stones, an enlarged prostate, birth defects, nerve problems, and tumors



There are various urinary diversion techniques, each with advantages and disadvantages. These include: 


  • Ileal continent urinary diversion

  • Neobladder

  • Indiana pouch.


Ileal continent urinary diversion: During ileal continent urinary diversion, the entire bladder and the draining lymph nodes are removed and sent for biopsy. A part of the small intestine is used as a storage unit for urine where both the ureters from the kidney connect. A part of this intestine is removed from the abdominal wall to create a stoma where a bag is created to collect urine. 


Neobladder: Once the urinary bladder and lymph nodes are removed, a new bladder is fashioned from the small intestine that connects the urethra. Patients can pass urine from the natural urinary passage and do not require a urinary bag on their stomach permanently. 


Indiana pouch: A part of the large intestine is removed during this operation, the ureters are placed, and the pouch is then attached to the inner wall of the abdomen, typically close to the belly button. A stoma is created in the pouch to allow drainage. A catheter is then inserted through the stoma to drain the pouch several times. Unlike a urinary conduit, the patient has no bag outside their body.  


Dr. Niren Rao, a leading urologist at Delhi Urology Hospital, is known for performing the best Bladder Cancer Surgery in Delhi. The hospital has the latest technology and performs endoscopic, laparoscopic and open surgical procedures for bladder tumors. The expert doctor understands that no two patients are similar, so he creates a customized treatment plan considering the age and health of the patient and cancer’s stage. 


To know the cost of bladder stone surgery in Delhi, book a consultation with Dr. Niren Rao at Delhi Urology Hospital today!   




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