Open surgery for bladder cancer

For aggressive tumours that have grown into the wall of the bladder, a complete removal of the entire bladder (cystectomy) is often required. For reasons of radicality, the prostate and seminal vesicles are removed in male patients. In women, the uterus and part of the vaginal vault are removed.

In both sexes, an extensive regional removal of the lymph nodes is appropriate. Before surgery, the choice of new urinary diversion should be carefully considered. The urinary diversion entail an intermediate piece designed as a stoma in the abdominal wall (ileal conduit) or the reconstruction of a replacement bladder from various parts of the intestine.

The procedure must first be discussed with the patient. Decisive factors include the age of the patient, the supposed remaining life expectancy, renal function, comorbidities, and the cosmetic requirements of the patient. 

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