Bladder cancer

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Cystoscopy

Female urinary tract

Male urinary tract

CONTINENT URINARY RESERVOIR

A continent urinary reservoir is another method of creating a urinary diversion. In this method, a segment of colon is removed and used to create an internal pouch to store urine. This segment of bowel is specially prepared to prevent reflux of urine back up into the ureters and kidneys, and also to reduce the risk of involuntary loss of urine. Patients are able to insert a catheter periodically to drain the urine. A small stoma is placed flush to the skin. Possible complications include: bowel obstruction, blood clots, pneumonia, urinary tract infection, skin breakdown around the stoma, ureteral reflux, and ureteral obstruction.

ORTHOTOPIC NEOBLADDER

This surgery is becoming more common in patients undergoing cystectomy. A segment of bowel is folded over to make a pouch (a neobladder or "new bladder"), then attached to the urethral stump, which is the beginning of where the urine normally empties from the bladder.

This procedure allows patients to maintain some degree of normal urinary control, although there are complications, and the urination is usually not the same as before surgery. For example, this procedure can be associated with leakage of urine at night, the need to perform manual catheterization periodically, and other complications listed above for the continent urinary reservoir.

Some patients may not be good candidates for this procedure. Discuss the pros and cons of this procedure with your urologist.

Patients will be closely monitored for progression of the disease regardless of the type of bladder cancer treatment received. Monitoring may include:

• Cystoscope evaluations every 3 to 6 months after initial treatment for people with stage I disease.
• Periodic urine cytology evaluations for people whose bladders have not been removed.
• Bone scan and/or CT scan to check for metastasis.
• Complete blood count (CBC) to monitor for signs and symptoms of anemia , which would indicate the disease has progressed.
• Monitor for other signs of disease progression, such as fatigue, weight loss, increased pain, decreased bowel and bladder function, and weakness.