Bladder cancer surgery can treat and even cure bladder cancer. It may also affect your quality of life. That’s why our bladder cancer team works together to consider every possible treatment option. Your care plan not only reflects the best way to manage your diagnosis, but also your quality-of-life preferences and goals.
Cystectomy & Bladder Cancer Surgery: Why Choose the Abramson Cancer Center?
The right bladder cancer surgery for you depends on whether the bladder cancer is muscle invasive or non-muscle invasive (superficial). Non-muscle invasive cancer has not spread beyond the bladder’s inner lining. Muscle invasive cancer has spread to the muscle tissue, and sometimes further.
If you choose to have surgery at the Abramson Cancer Center, you can expect:
- Skilled bladder cancer surgeons: Our surgeons have honed their skills with years of training and experience. They treat more than twice as many patients as the average cancer surgeon. Research and our own experience show that treating a high number of patients makes a difference. Our patients experience fewer complications and better outcomes.
- Team approach to care: Our surgeons are compassionate caregivers who work closely with other Penn Medicine specialists to ensure you receive complete care.
- Minimally invasive options: Many of our patients benefit from robotic cystectomy to remove all or part of the bladder. Robotic cystectomy’s advantages include less blood loss and a quicker recovery. At the Abramson Cancer Center, we have one of the most experienced robotic-assisted surgery teams in the world. Our experience, bladder cancer expertise and advanced technology have helped us rank among the best programs in the Philadelphia region.
- Focus on your quality of life: Our surgeons are experts in urinary diversions, surgeries that create new ways for the body to store and pass urine. Their expertise allows many of our patients to preserve function after cystectomy. Our surgeons also specialize in vaginal-preserving cystectomies to avoid the removal of the vagina, uterus and ovaries.
- Advanced technologies: Our surgeons use the latest technologies to better find and remove cancerous tissues during surgery. One investigative technology is called intraoperative molecular imaging, or TumorGlow®, a dye that makes cancer cells light up during surgery. Surgeons use TumorGlow to find tumors that did not show up on imaging. They also use it to remove cancer more precisely to protect healthy tissues. Learn more about TumorGlow technology.
Bladder Cancer Surgery During the COVID-19 Surge: Craig’s Story
When Craig was diagnosed with bladder cancer at the height of COVID-19’s first wave, he turned to the Abramson Cancer Center. From health care providers in full PPE to recovery via telemedicine, Craig experienced many different safety processes — but the same high surgical standards. Read Craig’s story.
TURBT for Non-Muscle Invasive Bladder Cancer
You may need to undergo a transurethral resection of bladder tumor (TURBT) procedure to treat non-muscle invasive bladder cancer. It is also known as transurethral resection (TUR).
In a TURBT procedure, your doctors:
- Give you anesthesia to make you sleep or numb part of your body
- Insert a thin, lighted tube called a cystoscope into the bladder through the urethra (the tube that allows urine to leave your bladder)
- Insert a tool through the cystoscope that removes the cancer
Treatments After TURBT
At the Abramson Cancer Center, we have several tools to ensure we destroy all the cancer, including:
- Blue light cystoscopy: Blue light cystoscopy uses ultraviolet (UV) light and a special dye to make cancer cells glow bright pink. This unique technology shines a spotlight on smaller, hidden cancers that surgeons may miss with standard cystoscopy. It also helps prevent cancer recurrence (when the cancer returns). Learn more about blue light cystoscopy.
- Intravesical therapy: Your doctors may also recommend intravesical therapy after a TURBT. During this treatment, doctors put cancer-killing drugs directly into your bladder. These drugs destroy any cancer cells that may remain. Read more about bladder cancer treatment.
After a TURBT, you may also undergo intravesical therapy. During intravesical therapy, your doctor puts chemotherapy or immunotherapy drugs directly into your bladder. These treatments kill remaining cancer cells.
If TURBT isn’t effective at eliminating bladder cancer, bladder removal (cystectomy) is often the next step. But at the Abramson Cancer Center, you may have the option to join one of several clinical trials to keep your bladder.
Cystectomy (Bladder Removal Surgery)
A cystectomy is surgery to remove all or part of the bladder. Surgeons may also remove any lymph nodes or nearby organs if cancer has spread. Our surgeons perform more cystectomies than any other hospital in the Philadelphia region. This experience leads to better outcomes.
Our surgeons perform both open and minimally invasive cystectomies. In an open cystectomy, doctors remove your bladder through an incision in your lower abdomen. In minimally invasive procedures, doctors access your bladder using special instruments and tiny incisions. Your doctor will discuss the best choice for you.
Chemotherapy before (neoadjuvant) or after (adjuvant) the cystectomy may also be a part of your treatment plan. Chemotherapy is an effective way to shrink the tumor for easier removal.
Radical Cystectomy
In a radical cystectomy, surgeons remove the entire bladder along with nearby lymph nodes and organs that contain cancer cells. In males, these organs may include the prostate and seminal vesicles (reproductive glands that produce the fluid in semen). In females, they may include the uterus, ovaries or part of the vagina.
Typically, we give chemotherapy before a radical cystectomy. Chemo helps shrink the tumor and increases the likelihood that your surgeon can remove all the cancer.
Partial Cystectomy
In a partial cystectomy, surgeons remove only part of the bladder. Partial cystectomy allows you to maintain urinary function. If you have cancer that has only invaded part of the bladder and muscle tissue, this surgery may be an option for you.
Urinary Diversion (Urostomy)
Here’s how urination normally works:
- Your two kidneys make urine.
- The urine leaves the kidneys through two thin tubes called ureters.
- The ureters pass the urine into the bladder.
- The urine leaves the bladder through another tube called the urethra.
- The urine exits your body through the urethra.
If you have a cystectomy, you no longer have a bladder and need a new way to store and release urine. Urinary diversion procedures make this possible.
There are several types of urinary diversion procedures, each with its own pros and cons. Our doctors spend the time needed to help you understand your options and choose the best one for you. These options include:
Ileal Continent Urinary Diversion
During an ileal urinary diversion, your surgeon:
- Removes a piece of your small intestine (ileum)
- Connects the ileum to your ureters (tubes that carry urine from your kidneys to the bladder), creating a new route (ileal conduit) for the urine to drain from your body
- Brings the end of the ileum out through an opening (stoma) in the wall of your abdomen (stomach)
After the procedure, you must always wear a small bag on your abdomen that collects urine from the stoma.
Neobladder
After a radical cystectomy, it’s often possible to create a new bladder. This method is possible if you have full kidney and liver function and no cancer in the urethra. Doctors make this neobladder using tissue from the intestines.
Here’s how it works:
- Your surgeon positions the neobladder inside the body in the same position as the original bladder.
- The kidneys filter as they always did and deposit urine into the neobladder.
- The neobladder holds the urine until you can release it.
Many people learn how to control the release of urine from the neobladder like they did with a normal bladder. If this is not possible, you must insert a catheter (long, thin tube) to empty the neobladder.
Indiana Pouch
An Indiana pouch is a form of continent urinary diversion that eliminates the need for an outside bag. Your surgeon instead:
- Makes a urinary pouch from your intestine
- Connects the pouch to the urethra
- Connects the pouch to the abdominal wall, which forms a stoma
To urinate, you periodically drain the pouch using a catheter that you insert in the stoma.
Make an Appointment
Please call 800-789-7366 or request a callback.