Bladder cancer surgery

14-07-2020

Bladder cancer is a common type of cancer. Men suffer from this disease a little more than women, mostly after the age of 50 or 60. Medicine has recognized that smoking is one of the main causes of bladder tumors. In addition to examinations, urology specialists at Atlas General Hospital also perform urological surgeries and interventions.

Bladder cancer – symptoms

Dr. Uroš Babić: “ The symptoms are different. The cardinal sign, which occurs in patients with bladder cancer, is the so-called total painless hematuria- the presence of blood in the urine. It is not accompanied by pain, unlike other medical urological conditions, which have pain and the appearance of blood. So that is a cardinal sign. However, what is a problem is that in a large number of patients, this disease occurs completely asymptomatically- without any symptoms. Sometimes, in these patients, the diagnosis is made in a situation when healing is practically difficult. Most of the patients come to check-up at a time when complete cure is possible, when the disease is localized to the bladder- bladder mucosa. There are over 60% of such cases. ”

Bladder cancer

Dr. Babic explains that patients usually had no symptoms or so-called total painless hematuria, the presence of blood in the urine. The disease is usually diagnosed during routine ultrasound examinations.

Dr. Uroš Babić: “ The changes are quite clear and recognizable on ultrasound. When something suspicious is noticed on the ultrasound examination, a further diagnostic algorithm is taken. The next is a cystoscopic examination. It is an endoscopic examination that involves the introduction of an endoscopic device, through the urethra, into the bladder. The “naked eye” recognizes possible changes in the bladder, and then, based on the aspect, location and size, it is assessed whether it is necessary to do something else from the diagnostics, and that is a scanner or magnetic resonance imaging. After that, further treatment is planned. ”

Bladder cancer - ultrasound

When a cancer in the bladder is diagnosed, the first model and gold standard in the treatment of this disease is transurethral resection of the tumor (TURBT). It is done endoscopically and leads to healing in most patients.

Dr. Uroš Babić: ” Transurethral resection of the tumor involves endoscopic entry into the bladder, through the urethra, with a device that has one loop through which current is conducted. Such an operation aims to remove the tumor tissue in the lumen of the bladder, to make a complete resection, that is, to remove everything that is possible from the tumor and to remove a part of the surrounding tissue. Conditionally speaking, this reflects the radicalism of this operation, although this operation is not radical. It is an operation that is intended for tumors that are localized in the bladder.

If it turns out that the tumor is only on the bladder mucosa, then this type of surgery is a possibility that leads to healing in a number of patients. Relapses are possible in a number of patients, so this type of surgery can be repeated. In others, however, the disease takes hold. In that case, another operative radical treatment is needed-the one that involves removing the bladder. For most patients, the therapeutic choice is sufficient to lead to a cure. This therapy is supplemented by various intravesical applications of hemostatics or BCG vaccine. It is then a long-term and quite frequent “socializing” with urologists, unfortunately for patients. If the “socializing” lasts a long time, then in a way it is happiness for the patient because we are talking about long-term survival. ”

Transurethral resection

Bladder cancer – surgery

Dr. Uroš Babić: “ Endoscopic surgery, as minimally invasive, is very favorable for the patient. So there is no skin cutting. Surgery should turn out to be a sufficient way to treat the tumor. The duration of the operation depends on the size of the tumor. Sometimes even very large tumor masses can be removed in this way. However, average length of the operation is one hour. The operation can sometimes be performed in two acts.  It is possible to postpone the operation for a month, if it is not possible to remove the entire tumor in one act.

In the next act, the tumor can be removed completely. Of course, provided that the tumor is localized, that it has not progressed locally, because then that is not an option. Most patients recover fast after this operation. What is a fairly common complication is that there is prolonged bleeding, the appearance of blood in the urine. This is mostly solved by conservative measures, and most patients go home on the first or second postoperative day. Patients have a urinary catheter in the bladder that is placed at the end of the operation. The urinary catheter is removed before leaving the hospital and then the urine is cleared. The catheter is then removed and the patients go home in good general condition. ”

Bladder cancer surgery

According to Dr. Babic, no special recovery is needed after the surgery. If patients are able to work, they return to daily activities very quickly and have a good quality of life. Only check-ups are mandatory because the disease can return, and bladder tumors have very high malignant potential.

Is there prevention for bladder cancer?

Dr. Uros Babic: ” The need for screening, related to bladder tumors, is not recognized in the general population as a measure that leads to a higher percentage of cures. The fact is that if the tumor is detected earlier, the chances of a complete cure are very high. ”

At least once a year, each of us, for various reasons, goes for an ultrasound examination. Ultrasound examinations are important because they can identify a tumor, and then further diagnosis follows.

Dr. Uros Babic: ” What absolutely all patients who suffer from this disease can do is to stop smoking. Tobacco smoke is an absolute, unequivocal and scientifically proven main cause. This is one of the risk factors that can be avoided. We always draw the attention of patients who suffer from this disease, who enter this treatment and monitoring regime, to the fact that it is very important to stop smoking. Smoking cessation leads to a delay or complete absence of relapse. So, all aspects of treatment are much better in a situation when the patient decides to take such a step. ”

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If you have a urological problem or need an examination, you can call the call center of Atlas Hospital on 0117858888 or 0603292411. Our team of specialists will do their best to help you and if possible diagnose and treat the problem.