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Transurethral Resection (Tur)
This mainly deals with diagnosing the bladder cancer and removing the related tissues from the bladder. Also known as the TURBT or transurethral resection for bladder tumor, doctors generally carry this out with an anesthesia, which could be general or spinal. The two surgery tools that are used are:
- A cystoscope : This is inserted into the bladder through the urethra
- A Resectoscope: This tool is useful for taking the cancer growth for a biopsy. It also helps to burn the cells left behind.
Bladder cancer has a tendency to occur again. Therefore, it is good to repeat this transurethral resection method.
Reasons for This Type of Surgery
There are only three reasons for this kind of surgery:
- Diagnosis: This surgery is useful in the examination of the urinary bladder and any kind of cancerous growth is easily detectable.
- Staging: This surgery plays a key role in finding out if the cancer is attacking the bladder lining.
- Treatment: Some of the tumors that form within the bladder are removed by this method.
Post Surgery Care
The bladder cancer surgery involves a little bit of post surgical care. A catheter is positioned in the urethra. This catheter ensures that there is no post surgical bleeding thus resisting any kind of possible block to the passage to the urethra. The catheter is removed only after there is a cess in the bleeding. The patient undergoing this surgery would have to be hospitalized for at least five days.
The Patient
The patient who has undergone a TUR kind of bladder cancer surgery would have an urge to pass urine frequently for some until after the surgery effect weans off. This heals over a period. Traces of blood are observed in the urine at least a fortnight after the surgical procedure.
Care After Surgery
The patient would be asked to refrain from any kind of strenuous exercise, activity etc. The patient is under observation for more than 21 days after the surgery is over.
Tur – Its Benefits
This is the most common and most successful form of bladder cancer surgery. This is used to treat superficial bladder cancer at its initial condition. It could be applied to late stage cancer also provided all the cancerous growth are removed and the biopsy report confirms the bladder to be cleansed of all the remaining cells within.
Risks
As with any other surgery, this kind of surgery also has its risks and disadvantages. They are:
- Bleeding
- Bladder infection or cystitis
- Perforation of the urinary bladder wall
- Hematuria or blood in the urine
- Urethral block caused by clots of blood in the bladder
- Bladder Wall perforation
- Hematuria: Blood in the urine
- Blockage of the urethra by blood clots in the bladder.
Cystectomy
This kind of urinary bladder cancer surgery is done in a condition where the entire bladder or parts of the bladder are removed. This normally is done if the cancer has seen to affect the muscles of the bladder.
Cystectomy could be of two types:
- Total or radical cystectomy: The whole bladder along with the surrounding organs in the pelvic region is removed.
- Partial Cystectomy: In this surgery, the surgeon removes only the cancer that has affected.
Normally this treatment is used when the bladder has spread too far and has entered the second and third stage.
Post Surgical Care
Once the doctor removes the bladder surgically, he creates a passage for direction of the urine. This diversion is of two types - continent diversion or non-continent diversion. In continent diversion, a pouch is attached to the abdomen. It can be:
- Abdominal diversion reservoir: There is an abdominal pouch. This is connected to a stoma in the skin. Thus, the person need not feel conscious of having a pouch outside the abdomen.
- Orthotopic diversion: The pouch is a connection between the urethra and the ureters allowing the urine to pass through the same opening as before.
Non-continent diversion could be a urostomy or an ileal conduit diversion. The ureter is connected to the surgically created stoma or an opening in the abdomen with the help of a channel. Urine collects in the bag. This bag is emptied after three days. The body gives signals that the bladder is full. This surgery could prevent the body from continuing this. In addition, the person faces a problem with digestion. Thus, we should take proper care.
