What consequences can be after removal of the bladder in men?
Indications for removal of the bladder
It should be noted that, as a rule, unequivocal indications for gall bladder removal take place starting from the 2nd stage of the cancer and with a significant defeat of this body. In this case, it is usually when papillary carcinoma shows a complete removal of the bladder. Operations of this kind are called radical cystectomy has a segmental - removal of part of the body) and must be accompanied with a particular method of bladder reconstruction.
During cystectomy MP is removed and the ureters are transplanted, for example, in the sigmoid colon. In addition to the 2-4 stages of cancer, doctors often recommend radical surgery in the case when diagnosed with cancer 0-1 degree, but after alternative therapies (chemo-, radiotherapy, etc.), the tumor continues to grow, i.e., is highly malignant.
As other effective treatments, usually performed intravesical introduction of anticancer agents, immunotherapy, brachytherapy, etc. In some cases, is transurethral resection (0-th stage of the cancer) or segmental cystectomy of the bladder (1-3 stages of cancer affected part of the body.
The specificity of radical cystectomy
Surgery for total removal of the bladder, or radical cystectomy, is performed in case of lesion of this organ cancerous tumor.
As noted above, there are two main ways of urinary diversion after it was carried out the removal of the bladder is the method of Bricker and Studer. These methods of implementation cystectomy differ primarily by the effects of the operation.
Advantages of the method of Bricker are:
- minimal surgical intervention;
- simple organization drain urine;
- there's no need to use a catheter.
The negative consequences of this method include:
- high probability of back urine reflux into the kidneys, leading to pyelonephritis, etc.;
- the need to use external storage and, consequently, the dependence of their quality, safety and timely replacement;
- high probability of infection derived out of the holes to drain urine;
- physical and mental discomfort, decrease in the quality of life.
As for the method of Studer, it has the followingpros:
- low probability of back urine reflux into the kidneys and, accordingly, the development of kidney infections;
- the process of urination as close to natural;
- quality of life after surgery.
The disadvantages of the method:
- long time of surgery and at high risk of developing complications;
- a long period (up to 12 months) to develop the skills of urination with reconstructed bladder;
- the possibility of periodic use of a catheter to ensure emptying of the bladder.
At first glance, the Studer method is more preferable in comparison with the method Bricker, because it provides more high quality of life for the patient, however in some cases there are contraindications to surgery to create an artificial bladder. Such prohibitions are:
- chronic diseases of the gastrointestinal tract;
- mental disorders;
- renal failure etc.
I should say that the choice of a particular way of organizing urination after radical cystectomy depends on a number of factors - the age of the patient, stage of cancer, presence of chronic diseases of internal organs, mental disorders, etc.