Bladder Surgery

For patients with superficial bladder cancer, the standard surgical treatment is to remove the cancer from the bladder using a traditional scope inserted through the urethra.

If you have invasive bladder cancer, you may be eligible for a bladder-sparing procedure called partial cystectomy. This procedure can be done in a traditional open or robotic-assisted method and it allows you to keep most of your bladder, which helps you retain mostly normal bladder function.

During this procedure, your surgeon may also remove nearby lymph nodes in the pelvis to determine if the cancer has spread. Depending on your results, follow-up immunotherapy or chemotherapy inside the bladder or throughout the body after surgery may be needed.

If you have invasive bladder cancer – meaning the cancerous cells have spread into the muscles of the bladder – your entire bladder may need to be removed, along with some or all adjoining structures. Your doctor may recommend a traditional open procedure or a robotic-assisted procedure. Temple’s urologic oncology team has extensive experience conducting radical cystectomy and managing patients after this complex procedure. 

If you have invasive bladder cancer, you may need to have your lymph nodes in your pelvis removed. This procedure is called a pelvic lymphadenectomy (PLND). Some research has found this procedure improves cancer-specific survival in patients.

Removing the lymph nodes in the pelvis is complicated because they are wrapped around large blood vessels and nerves. It’s essential to choose a surgeon who has significant training and experience in this procedure, like our surgeons at Temple Health.

After your bladder is partially or completely removed, you may elect to undergo bladder reconstruction. There are three main surgical options for bladder reconstruction:

• The Neobladder Method – This procedure creates a new bladder from part of the small intestine. The intestine is surgically connected to the urethra and ureters so the patient can continue to urinate through the urethra.
• The Conduit Method – This procedure attaches a smaller section of small intestine to the abdominal wall and ureter. Urine is collected in a urine bag that is worn on the outside of the body.
• The Reservoir Method – This procedure uses a section of the small intestine to create a pouch that collects urine inside the body. The patient must manually empty the pouch through a catheter every four to five hours.