According to the American Cancer Society, in 2011, approximately 70,000 people in the United States will be diagnosed with bladder cancer, and approximately 25% of them will eventually need to have their bladders removed to control the cancer. Bladder cancer occurs three times more often in men, usually between the ages of 50 to 70 years old.

You and your doctor are talking about a surgical procedure called a radical cystectomy as a way to control your bladder cancer. To help you get ready for your surgery, it is important for you to learn as much about this kind of treatment as possible. It is also important to learn how to manage your care following the surgery. You will learn:

• Description of the surgical procedure
• What to expect when you have a radical cystectomy
• What you need to do to prepare for the surgery
• How to take care of yourself after the surgery

The urinary system, which includes the bladder, urethra, ureters, and kidneys, helps maintain stable chemical conditions in the body, stores and eliminates waste products. The bladder, a muscular chamber located in the lower abdomen, acts as a reservoir to collect urine. Two narrow tubes called ureters carry urine from the kidneys to the bladder. From the bladder, urine is empted through another tube, the urethra, during urination.

The surgical procedure in which the bladder is removed is called a radical cystectomy. Bladder cancer tends to spread to other areas of the body, and thus the bladder and the surrounding organs are usually removed.

In men, the prostate, seminal vesicles, and surrounding lymph nodes are removed. Men will not ejaculate after surgery. Although the ability to have an orgasm is not affected, many men may not be able to have a penile erection. It may be possible to spare the nerves controlling penile erection in some men. In these cases, restoration of potency usually occurs within one year of surgery. Alternative methods of achieving an erection can be used and should be discussed with your surgeon.

In women, often the ovaries, fallopian tube, uterus, cervix, part of the vagina, and surrounding lymph nodes are removed. Women who have their cervix or part of their vagina removed may have difficulty with sexual intercourse during the first few months after surgery. After several months, the tissue in the vagina may relax and lengthen, making sexual intercourse possible.

We personalize treatment plans to each individual patient. Some patients are best treated with an open operation. Many patients can now be treated using a robotic-assisted laparoscopic operation. In the open operation, an incision is made in the abdomen from the navel to the pubic bone. In the robotic-assisted laparoscopic operation, 6 small incisions (cuts) are created to insert the laparoscopic ports during the cystectomy portion of the surgery. A small incision is made in the abdomen to remove the bladder and lymph nodes as well as to create the urinary diversion, although this is done robotic-assisted laparoscopically in selected patients. Advantages of the robotic-assisted laparoscopic surgery can be decreased blood loss, earlier return of bowel function, shorter hospital stays, and earlier return to full activities.

Journal of Nephrology and Urology is an Open Access peer-reviewed publication that discusses current research and advancements in diagnosis and management of kidney disorders as well as related epidemiology, pathophysiology and molecular genetics.

To submit a new manuscript authors should use the online submission system. Authors may submit their manuscript via online tracking system https://www.imedpub.com/submissions/nephrology-urology.html or as an attachment to email:  nephrolurol@imedpubjournals.com

Regards
Mercy Eleanor
Editorial Assistant
Journal of Nephrology and Urology