Causes and Risk factors:
Smoking causes about half of all bladder cancers.Certain industrial chemicals, eg:aromatic amines used in dye, rubber, leather and textiles.Lynch syndrome is a familial syndrome linked mainly to bladder,colon and endometrial cancer.
Blood in the urine without much pain (called painless hematuria) is usually the first sign. Sometimes bladder cancer can cause irritative urinary symptoms. In advanced stage patient looses weight & appetite and can have bony pains.
Depending on the depth of bladder wall invasion bladder cancer can be categorized as superficial (Non-muscle invasive) and deep (muscle invasive).
Endoscopic resection of bladder tumors or laser fulguration of tiny lesions (TURBT) is usually sufficient for superficial tumors. To reduce the recurrence few patients may need additional intravesical therapies i.e instillation of drugs into the bladder.
Radical cystectony is the treatment of choice in muscle invasive cancers. This surgery involves removal cancerous bladder and surrounding lymph nodes. Urine diversion is done by ileal conduit (urine tubes or ureters are attached to a segment of small intestine and this is brought out through the tummy wall as stoma to which a urine bag is applied). In selected patients neobladder can be created where intestinal segment is used to create a reservoir similar urinary bladder, facilitating urine passage naturally.
We at AINU perform these surgeries completely by Robot, called Robotic Radical cystectomy with intracorporeal ileal conuit/neobladder. Advantages are less blood loss, less postoperative pain and early recovery.