Doctors diagnose 60,000 new cases of bladder cancer annually, according to the University of Southern California Institute of Urology. The majority of bladder cancers are confined to the superficial layers of the bladder at diagnosis; in 25 percent of cases, however, the cancer spreads into the deeper layers of the bladder. For patients whose cancers have spread, treatment involves partial or complete removal of the bladder, a procedure called a cystectomy. After cystectomy, surgeons must create an alternate way for the patient to eliminate urine.
Symptoms
Patients with bladder cancer may present with several different symptoms. The main symptom of bladder cancer is blood in the urine, according to the University of Southern California Institute of Urology. This bleeding is usually painless and may be unnoticeable to patients. The amount of blood may be microscopic and only measurable with laboratory testing. Bladder cancer may also cause symptoms of urinary frequency or urgency. Because these symptoms may be associated with other conditions, patients should discuss them with their doctors.
Partial Cystectomy
In bladder cancer located in one area of the bladder or cancer that has not invaded deeply into the bladder, a surgeon may elect to perform a partial cystectomy, according to the American Cancer Society. During a partial cystectomy, a surgeon removes only a portion of the bladder. If the cancerous area of the bladder is near an opening in the bladder through which urine enters or exits, a partial cystectomy may be inappropriate, according to CIGNA.
Radical Cystectomy
A radical cystectomy is another treatment for bladder cancer. A radical cystectomy is an extensive procedure, explains the University of Southern California Care Medical Group. In men with extensive bladder cancer, a radical cystectomy involves the removal of the entire bladder, the pelvic lymph nodes, the prostate and the seminal vesicles. In women, this procedure requires the removal of the bladder, uterus, ovaries, fallopian tubes and part of the vaginal wall. In some patients, surgeons may be able to spare childbearing potential and still remove all of the cancerous tissue.
Urinary Diversion
If surgeons remove a patient's bladder, they also provide an alternate way for a patient to urinate. They may create a surgical opening through the abdomen using a portion of the small bowel---a procedure called a urostomy---according to Cancer Research UK. In this procedure, the urine empties continuously into a bag outside the body. In another procedure, surgeons create a pouch inside the body using part of the intestine where the small and large bowels meet. This pouch is connected to a hole in the abdomen. At this juncture, the bowel contains a valve and the patient can insert a thin catheter into the hole to remove urine when necessary. With this method, the patient remains continent---meaning that urine is stored within the body and not in a bag. Surgeons can also create a new bladder from a piece of a patient's small intestine and attach the ureters and the urethra to the new structure.
Risks
According to the American Cancer Society, cystectomy may have serious complications. Urinary tract infections, incontinence or urinary leaking or obstruction of urine flow are all possible complications of cystectomy. Patients may also develop an infection of the intestine that can lead to peritonitis, which is an infection of the abdominal wall, according to Surgery Encyclopedia. Depending on the extent of the surgical procedure, both men and women may also experience sexual dysfunction after a cystectomy.
