What Are The Causes of Bladder Cancer?
Bladder is a sphere-like organ that sores the urine coming from both kidneys through urinary tracts (urethra). Malign tumors originating from the inner side of this organ is called bladder cancer. Bladder cancer is more common in men than women. Smoking and chemical substance exposure observed in some factories are among its known causes.What are The Symptoms?
The most important symptom is blood and clots in the urine without pain. In addition, depending on the type of the cancer, complaints like persistent pain during urination and sense of burning towards the end of urination are also reported. This bleeding may not be visible sometimes, but it will be detected in the urine analysis.How Is It Diagnosed?
Usually, a mass in the bladder can be easily diagnosed with abdominal or urinary system ultrasonography, and upper and lower Computed Tomography with contrast agent can be used for diagnosis as well. However, when these examinations are unable to provide a definitive diagnosis, that a method involving the insertion of a camera system through urinary meatus in order to visualize inside the bladder can be used. After diagnosis, Closed TUR Tm (Trans Urethral Resection Tm) operation is performed with an endoscopic camera.How is TUR Tm Performed?
Operation can be performed under general or local anesthesia. Bladder is accessed through urinary meatus and the cancerous section is completely removed and samples are collected from all layers of the bladder by using a special electrical device. The patient can stand up the next day, urinary catheter is generally removed on second or third day and the patient can be discharged.
When is Radical Cystectomy Required?
In this operation; bladder, prostate, portion of the lower urinary tract, seminal vesicles, and lymph nodes around the major surrounding vessels are removed. It takes for 6-8 when performed fully, patient is taken to intensive care for at least 24 hours if needed, and then transferred to the ward. Patients can return home 10-14 days after the operation.Why The Removal of Lymph Nodes and Its Number is Important?
This is likely the most critical part of the radical cystectomy operation. Removing lymph nodes requires specialized training and experience. Additionally, the greater the number of lymph nodes removed, the longer the patient's life expectancy tends to be. If cancer is found in the lymphatic tissues, it is possible to accurately determine the disease's progression, which is essential for planning appropriate additional chemotherapy.
How Do Patients Urinate After the Bladder Is Removed?
The most common method is called an "ileal conduit. In this procedure, both ureters (the tubes that carry urine from the kidneys) are connected to one end of a 12“15 cm segment of the small intestine. The other end of this intestine segment is brought out through an opening in the abdominal wall. Urine flows through this segment and collects in a bag attached to the skin, which patients empty as needed. The urinary bag should be replaced every 2“3 days. Another method involves forming an artificial bladder from the intestine, known as a "neobladder" or "orthotopic bladder," which is a significant alternative to older methods and allows for more normal urination.
What Are The Advantages of Forming a Bladder With Intestines?
When the removal of the bladder is necessary, it can be difficult for patients to make this decision, and delaying the procedure can negatively impact their lives. The most significant benefit of an artificial bladder (neobladder) is that it does not reduce quality of life and is considered socially acceptable.
This operation is performed to enable patients to urinate normally and to provide them with a more comfortable life. During the procedure, a section of the small intestine is reshaped into a spherical reservoir, and both urinary tracts that connect to the kidneys are attached to this new bladder. One end of this artificial bladder is then connected to the urinary tract within the penis. Approximately 15“18 days after surgery, the urinary catheter is removed, and patients are trained to urinate using their new bladder. Learning to urinate with the neobladder usually takes four to five days, after which patients are able to fully empty their bladder.