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Reconstructive surgery for bladder cancer

What is reconstructive surgery?

If the entire bladder is removed with a radical cystectomy, then an alternative pathway in the body is needed for urination. Creating this new route is part of reconstructive surgery.

Reconstructive surgery for bladder cancer

There are several ways for urine to be removed from the body when the bladder has been removed.

One approach our surgical oncology teams may use is to remove a small piece of intestine and connect it to the ureters, creating a passageway (called an "ileal conduit") for urine to pass from the kidneys to the outside of the body. An opening, or stoma (also called "urostomy"), is made on the front of the abdomen, and the conduit is connected to this hole.

Another way to remove urine is with a "continent diversion." Here, a pouch is made from a piece of intestine, and a valve is created in the pouch. Urine is stored in the pouch. Several times each day, the pouch is emptied putting a drainage tube (catheter) into the stoma through the valve. With this approach, there is no bag on the outside of the body.

A third, newer approach allows our surgical oncology teams to restore urination back into the urethra. In this procedure, a piece of intestine is used to create a place where urine can be stored. The ureters are connected to this "neobladder." The difference between this approach and the others is that the neobladder is sewn to the urethra, which allows for normal urination.

Another type of reconstructive surgery may be done when bladder cancer is in an advanced stage and cannot be removed by surgery. With this approach, urine is diverted away from the bladder, even though the bladder is not removed. This procedure can help prevent or treat any blockage of urine flow.

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