Bladder cancer is the fourth most commonly diagnosed cancer in men and the ninth most common cancer in women, reports the Fox Chase Cancer Center in Philadelphia. There are several ways of treating bladder cancer, based on the stage and extent of disease. Surgery is one of the main treatments. Depending on the severity of disease, different types of surgery may be performed.
Transurethral Resection
Transurethral resection, or TUR, is the most common type of surgery for early or superficial bladder cancers, according to the American Cancer Society.
This procedure entails inserting a cystoscope called a resectoscope through the urethra into the bladder. The end of the resectoscope has a wire loop at the end, enabling the surgeon to remove tissue after the surgeon is able to see into the bladder. No abdominal incisions are made with this type of surgery.
To make sure no cancer remains, the base of the tumor might be burned while the surgeon is looking through the cystoscope; this is called fulguration. Side effects can include mild bleeding or discomfort post-surgery, but these side effects are typically transient and resolve quickly.
Normal activities are usually resumed within two weeks, notes the American Cancer Society. A drawback to this surgery is the fact that if this procedure is done multiple times, scarring of the bladder might occur, possibly causing incontinence.
Cystectomy
When bladder cancer becomes invasive, a cystectomy may be done. A cystectomy involves removing part or the entire bladder. Different types of cystectomy are available.
The National Cancer Institute describes a radical cystectomy as the removal of the entire bladder, along with lymph nodes or nearby organs that may be cancerous. The surgeon will create an alternative route for urine to leave the body, since the bladder is taken out. If superficial cancer is widespread, a radical cystecomy may also be performed.
A segmental cystectomy removes part of the bladder; this procedure can be done if cancer has only invaded the bladder in one area. Because only a section of the bladder is removed, urinary function is preserved.
Bladder Reconstruction
When the entire bladder is surgically removed, a substitute mode of urine collection and excretion needs to be created. The American Cancer Society describes one option as removing a small part of the intestine and using it to connect the kidneys to the outside of the body.
After leaving the kidneys and passing through the ureters, the urine is collected in a small pouch made from the intestine; this pouch is attached to the abdominal skin, forming a stoma. A small bag is sometimes attached to the stoma to continuously collect urine.
The American Cancer Society also mentions a newer kind of bladder reconstruction in which a neobladder is created out of a piece of intestine. This substitute bladder routes urine back through the ureters and the urethra, enabling the patient to urinate normally.
