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Surgery for invasive bladder cancer.

J P Richie1

  • 1Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Hematology/Oncology Clinics of North America
|February 1, 1992
PubMed
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Bladder substitution surgery offers psychological benefits by eliminating urinary collection devices. However, challenges remain in achieving reliable orthotopic micturition and assured continence with current techniques.

Area of Science:

  • Urology
  • Surgical Oncology
  • Reconstructive Surgery

Background:

  • Bladder augmentation techniques are established, emphasizing spatulated bowel segments and protective drainage.
  • Principles for continent urinary diversion via total bladder replacement are less defined.
  • Existing procedures present challenges, including enuresis and inconsistent continence mechanisms.

Purpose of the Study:

  • To review the established principles of bladder augmentation.
  • To highlight the evolving challenges and patient-driven demand for total bladder substitution.
  • To underscore the need for dependable bladder substitution techniques.

Main Methods:

  • Review of established surgical principles for bladder augmentation.
  • Analysis of current challenges in continent urinary diversion and total bladder replacement.

Related Experiment Videos

  • Discussion of patient motivations for seeking bladder substitution.

    • Main Results:

    • Bladder augmentation principles are well-defined, focusing on bowel segment preparation and drainage.
    • Continent urinary diversion techniques face challenges in achieving consistent continence and orthotopic micturition.
    • Patient desire for improved quality of life drives innovation in bladder substitution.

    Conclusions:

    • While bladder augmentation is established, total bladder replacement requires further refinement.
    • Patient psychological benefits and the desire to avoid external devices are significant drivers for bladder substitution.
    • Continued innovation is anticipated to yield dependable bladder substitution procedures.