Radical Cystectomy which is the removal of the entire bladder or partial cystectomy procedures are determined by the extent of the bladder cancer. Bladder cancer may first be noticed by recurring symptoms such as blood in urine, frequent urination, urinary retention, or by subtle indicators such as microhematuria or cloudy urine. Dr Fernando J Bianco the Chief of Robotic Surgery and Dr Alan Nieder whose research interests are in bladder cancer will evaluate whether the bladder cancer is localized or has spread to other organs and will provide the operation that best fits the cancer that is harbored by their patients.

Radical cystectomy is chosen for cancer that has invaded the wall of the bladder and for those with advanced bladder cancer or recurring cancer. A flexible cystoscope is an instrument that can slide up the urethra and go into the bladder and allow the urologist to have a magnified view of the bladder lining. If the urologist sees a tumor or growth, it can be removed, or a piece of it can be removed and analyzed for cancer cells. Once the pathologist gives the report of the type of and how many cancer cells the specimen has the urologist may order an MRI or CT scan to further study the extent of the cancer and determine if the cancer has spread to the lymph nodes and other organs.

Even with the bladder surgery planned once the operation begins the surgeon will have a closer look and the ability to find even more cancer then was previously seen. If this is the case, the urologist will then have to adjust the initial plan and remove more of the bladder or other organs for the sake of the patient’s life. Having an internationally renowned urological team gives you the best decision makers for these critical moments. In woman, the bladder along with the urethra, ovaries, fallopian tubes, the uterus and part of the vagina may be removed. In men the prostate, vas deferens, urethra, lymph nodes and seminal vesicles may be removed along with the bladder.

Radical Cystectomy is the solution to saving many lives but if the bladder cancer is confined to limited areas of the bladder the offending areas can be cut out and the bladder can be sutured together allowing the bladder to still function. The Neobladder will of course be smaller since some of it has been taken away; this will make the patient not be able to hold as much urine in the bladder then previously possible.