Bladder surgery: recovery, repair and why (2023)

General description

What is bladder surgery?

Bladder surgery is surgery on the bladder, the organ that holds urine below the kidneys and above the urethra. The type of bladder surgery depends on what is being treated. Situations that may require surgery include:

• Bladder cancer.
• cystocela(Bladder drop / bladder prolapse).
• urinary incontinence(loss of bladder control).

What types of bladder surgery are there?

Most bladder surgeries are now performed robotically, meaning surgeons only need to make a small number of incisions and then place openings that allow the operation to be performed using a robotic arm. Open surgery is rare, and the incision is very long. Types of surgery include:

• Bladder exstrophy repair:This type corrects a birth defect where the bladder turns inward and attaches to the abdominal wall.
• Front road repair:Severe cystoceles (descended or prolapsed bladder) may require anterior (front) repair. In this type of surgery, an incision is made on the wall of the vagina and the tissue that separates the bladder from the vagina is tightened. The surgeon may also implant a permanent mesh graft of synthetic or biological materials to improve vaginal support.
• urostoma:Sometimes people who have lost their bladder need or want bladder reconstruction surgery. In a procedure called a urostomy, part of the intestine is removed and reattached to the ureter. This sends urine from the kidney to an opening (stoma) near the navel. A light, impermeable bag is placed over the stoma to collect urine. The bags can be emptied if necessary.
• New bladder urostomy:Part of the intestine can also form a larger pouch or "non-costal bladder". An ostomy bag or bladder is placed in the cavity left by the bladder and the urine is stored. A tube, also from the intestine, leads to the stoma in the abdomen, but in this case a valve allows the bag to be emptied at any time. No bags included. The new bladder can be attached to the urethra to allow urine to pass normally.

Bladder cancer is the most common reason people undergo bladder surgery. Depending on the stage and progression of bladder cancer, surgery may be combined with other treatments such as chemotherapy or radiation. There are many different types of surgery that can be done to treat bladder cancer. These programs include:

• radical cystectomy: This operation involves complete removal of the bladder. An incision is made in the abdomen, and the bladder and nearby organs are carefully examined to determine the status of the cancer and to determine whether it may have spread to nearby structures and organs. The bladder is removed together with other affected organs.
• Segmental or partial bladder resection.: Segmental cystectomy is an operation that removes part of the bladder. This procedure is reserved for patients with low-grade tumors that invade the bladder wall but are limited to one area. Because only part of their bladder was removed, they were able to urinate normally after recovering from surgery. Removing only part of the bladder is a possible option when the tumor is aggressive, but all evidence points to a solitary tumor confined to a specific area of ​​the bladder. Surgery reduces the size of the bladder, but a large part remains.
• Electrosurgical transurethral resection (TUR):This is a procedure in which a cystoscope (a thin, lighted tube) is inserted through the urethra into the bladder. A tool with a small wire loop at the end is then used to remove the cancer or burn the tumor with a high-energy current. This is called electrocautery.
• Urine diversion:This is surgery that creates a new way for your body to store and get rid of urine.

What does the bladder do?

The urinary bladder (not to be confused with the gall bladder) stores urine after it has been filtered by the kidneys. Urine flows from the kidneys through the ureters to the bladder, where it is stored, and then leaves the body through the urethra.

The bladder is made of flexible, muscular tissue that expands or contracts depending on the amount of urine it contains. Bladder muscles contract when they push urine through the urethra.

How common is bladder surgery?

By 2021, nearly 85,000 people are expected to be diagnosed with bladder cancer. It is the sixth most common cancer in the United States and the third most common cancer in men. Bladder surgery is often part of a bladder cancer treatment plan. Radical cystectomy (removal of the entire bladder) is a type of bladder surgery used to treat muscle-invasive bladder cancer (MIBC).

What type of surgeon performs bladder surgery?

Bladder surgery is performed by a urologist. Urologists specialize in male and female urinary tracts.

Is bladder surgery an inpatient or outpatient procedure?

It depends on the type of surgery you have. Ask your doctor if you need to be hospitalized. It could be days, it could be weeks.

Can you live without a bladder?

That. If you do not have a bladder, you will need to undergo a urostomy or non-bladder reconstruction surgery.

program details

What happens before bladder surgery?

Your doctor may recommend that you stop taking any medications that pose a risk of bleeding during bladder surgery. You should stop using the following medicines about a week before:

NSAIDs, including:

• ibuprofen (Advil®).
• naproxen (Aleve®).

blood thinners, such as:

• warfarin (Coumadin®).
• Klopidogrel (Plavix®).
• Acetylsalicylic acid (aspirin).

Some antibiotics, blood pressure medications, and herbal remedies or supplements may also be restricted. You will also be asked to stop smoking and using tobacco products. In addition to the negative health effects of smoking, smoking also carries increased risks during and after surgery. It has been proven that tobacco slows down the healing process and reduces the effectiveness of the immune system.

Do not stop taking your medicine without your doctor telling you to.

Your doctor may recommend that you change your diet the day before surgery and follow a clean liquid diet starting the morning before surgery. This includes juices, soups and jellies without pulp. It is also important to have someone to look after you after surgery as an immediate return to normal activities is not recommended.

What happens during bladder surgery?

There is no single way to perform all bladder surgeries. Each condition treated with bladder surgery requires a different approach or procedure. When you talk to your doctor about bladder surgery, make sure you understand and feel comfortable with what he explains to you.

Today, most bladder surgeries are performed by robots. This means that your surgeon will use several much smaller incisions, rather than an "open" procedure that requires one large incision. Performing surgery this way can shorten healing time, reduce risk factors, and reduce scarring during the healing process.

What happens after bladder surgery?

The details of recovery from bladder surgery depend largely on the type of bladder surgery you had. For example, in a transurethral resection, much less tissue is removed or disrupted during the procedure than in a radical cystectomy, in which the entire bladder is removed. Therefore, recovery time after surgery can vary. Your doctor will guide you through the recovery process, including urine tests (your doctor will test your ability to urinate on your own after surgery) and catheter care instructions.

Shortly after surgery, your doctor will need to see you again. Report any problems you had after the operation. If you have bladder cancer, you may need a camera inserted into your bladder to examine it.

Will I sleep during bladder surgery?

Yes, you will receive a general anesthetic to put you to sleep.

risk/benefit

What are the risks of bladder surgery?

Every operation has risks. Bleeding, infection and internal damage are common risks of any surgery.

What are the possible complications of bladder surgery?

Complications can occur during bladder surgery. Your risk is higher if you are over 60 or if you were born female. Possible problems include:

• Gastrointestinal disorders:Abdominal surgery can interfere with bowel function. Talk to your doctor about managing gastrointestinal problems.
• male reproductive health: Bladder cancer can spread to the prostate. During bladder surgery, your prostate may also be removed, which can affect your fertility.
• reproductive healthexistwomen: If your uterus is removed as part of bladder cancer surgery, you will not be able to get pregnant.
• urine diversion: If you have surgery that changes the path of urine (for example, from the ureter to the pouch), you may have complications. Urine can leak through openings in the body and an infection can develop.
• Hormonal changes:If bladder cancer has spread to the ovaries, it may need to be removed. Menopause is about to begin.
• inability to urinate:Some people, especially women who have had more than one cystectomy, cannot urinate right away. This usually does not last more than a week. A catheter (a tube that goes into your bladder or ureter) and a leg bag (a small bag that collects urine) will be placed. Your doctor will teach you how to use the device.

Recovery and Outlook

What is the recovery time? When can I return to work/school?

It depends on the program you get. Ask your doctor.

Do I have to limit my activities?

Do not exercise or lift heavy objects for at least a few weeks.

What can I eat and drink after bladder surgery?

Be sure to drink plenty of fluids. If you don't get enough water, you risk:urinary tract infection(urinary tract infection).

What medicines should I take?

Your doctor can give you pain medication. Ask about other medications before you go home.

when to call the doctor

When should I contact my surgeon?

Contact your surgeon if you have any of the following symptoms:

• Intense pain, especially when urinating.
• You can't urinate.
• His temperature is 100.4 degrees Fahrenheit (fever).
• There is blood in the urine.

When should I contact my regular doctor?

Contact your doctor if you develop any symptoms that require bladder surgery. Bladder cancer symptoms to report include:

• Hematuria (blood in the urine). This is the most common symptom of bladder cancer. Your urine may be red, pink, or dark brown.
• Urgent need to urinate.
• frequent urination.
• Pain during urination.
• Pain in the lower abdomen or back.