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Bladder Tumour Surgery

Overview: -

Urinary bladder cancer mostly occur in more than 60 years of age group but sometimes can also developed in younger age group too.

Smoking or any form of tobacco chewing is one of the major cause to develop this condition.

Symptoms: -

Blood in Urine is one of the main symptoms of this cancer. Apart from that, lower abdominal pain, persistence dysuria or backache can occur.

When disease in advance stage (4^th Stage) swelling in the leg, bone pain, weight loss, loss of appetite develops.

Investigation: -

Urine cytology might helpful to diagnose to high grade tumor.

Sonography abdomen can identify tumor, its size, swelling in the kidney.

Cystoscopy: -

It examine the bladder directory via endoscope so direct visualization of small tumor in to the urethra to bladder it can be done. If doctor seen anything abnormal, he or she might take biopsy to find out nature of suspicion reason.

 CT/MRI this test done to find out loco-regional extend of tumor as well as distant metastasis.

PET Scan usually done to find out recurrence of tumor rather than in initial imaging.

Stage: -

Tumor stage depend upon how much tumor infiltrate in to the bladder wall, not on intraluminal component.

Treatment: -

First stage : Tumor usually removed by endoscopy, depending upon the final biopsy further treatment carried out. Some high grade recurrent large tumor required radical cystectomy.

Second stage : Tumor usually spread within the muscle which required radical cystectomy and Urinary Diversion,

Urine diversion done by two method, ileal conduit and neobladder.

Advantage of Neobladder is that patient void through natural urinary passage, neoadjuvant chemotherapy can be consider.

Third stage : Usually required neoadjuvant chemo therapy followed by surgery.

Forth stage : Require chemotherapy and sometime palliative radiation.

Those patients who cannot undergo surgery radiation offered to them.