More than 70 percent of bladder cancers diagnosed are of this type. In these more advanced cases, cancer cells have spread from the lining of bladder into the muscle and possibly surrounding organs, and a radical cystectomy is usually needed. In this treatment, a surgeon removes the diseased bladder and possibly other surrounding organs, including the uterus, fallopian tubes, and ovaries in women, and the prostate and seminal vesicles in men. In the past, the only option for urine collection following surgery was an external bag called an ostomy. Now, because of a new procedure pioneered at Johns Hopkins, most patients are candidates for bladder reconstruction.
Doctors use a portion of the large bowel, which they fashion into a new bladder.
The new bladder is attached to the urethra allowing patients to urinate normally and eliminating the need for a urine collection pouch or ostomy. Today, most patients are candidates for this procedure. For patients where bladder reconstruction is not possible, doctors can make an internal storage pouch for the urine using a piece of small intestine. Patients are taught to use a small tube or catheter to drain the urine through a tiny, concealable opening in the abdomen. Both of these new techniques have significantly improved the quality of life for bladder cancer patients.