Bladder Cancer Surgery

A bladder is a hollow organ in the pelvis that stores urine before it leaves the body. Urine is made by the kidneys and then carried to the bladder through ureters (tubes). When you urinate, the muscles in the bladder contract and urine is forced out of the bladder through the urethra.

Bladder cancer occurs when the cells in the urinary bladder grow uncontrollably. In most cases, bladder cancer starts in the innermost lining of the bladder – called the urothelium or transitional epithelium. As cancer grows through these layers in the bladder wall, it becomes advanced, making it harder to treat. Over time, cancer can spread to other parts of the body, such as distant lymph nodes, the bones, the lungs and the liver.

To prevent the progression of bladder cancer, Dr Louw-Waldi Vlok offers various treatment options, including:

Trans-urethral resection of the bladder tumour (TURBT)

This procedure is the first-line diagnostic test and treatment for bladder cancer. During a TURBT procedure, a resectoscope is inserted through the urethra to reach the inside of your bladder. This tool has a surgical loop that either cuts off a sample of tumour tissue to be analysed to determine the stage of cancer or removes the entire tumour from your bladder (if it is small enough).

Bacille Calmette-Guerin treatments (BCG)

This is a form of immunotherapy or stimulation of the body's immune system to kill cancer cells. BCG is a sample of inactivated bacteria that increases the immune response against foreign cells, including cancer cells.

Hyperthermic intravesical chemotherapy

Intravesical chemotherapy is a cancer treatment involving injecting chemotherapy medication directly into the bladder. This procedure has been shown to help prevent cancer recurrence.

The chemotherapy causes the bladder lining to separate from the tissue layers underneath and pass through the urine. The aim of the treatment is for the bladder to grow a new lining free from cancer cells. A benefit of intravesical chemotherapy is that the drags can reach the bladder cells without impacting the rest of the body.

Cystectomy

A cystectomy is the removal of the bladder, and it is usually done when cancer has not responded to TURBT or intravesical treatments. Once the bladder has been removed, another way must be found for the body to drain urine. The operation, therefore, involves the reconstruction of the urinary tract for urinary diversions. There are many methods for reconstruction. Dr Louw-Waldi Vlok will discuss each option with you during your consultation.