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TYPES CAUSES SYMPTOMS DIAGNOSIS STAGES TREATMENT |
Bladder
reconstruction
The bladder is completely removed in radical cystectomy.
Removal of the bladder requires an ostomy (surgical creation of an artificial
opening) and an external bag to collect urine. This is called urinary diversion.
The continent urinary reservoir or catheterizable stoma, the neobladder, urinary
or ileal conduit are some procedure include in bladder reconstruction.
The urinary or ileal conduit is a urinary channel that is surgically created from a small piece of the patient's bowel (small intestine). During this procedure, the ureters are attached to one end of the bowel segment and the other end is connected to an opening (stoma) in the lower abdomen through which urine drains into a small bag. An external, urine-collecting bag can worn at all times and empty three or four times a day.
In continent urinary reservoir, a piece of the colon (large intestine) is used to form an internal pouch capable of holding three or four cups of urine. The urine cane be drained from the pouch with a catheter several times a day and the stoma site is easily concealed by a band aid.
In neobladder procedure, the surgeon literally recreates a bladder. The process involves suturing a similar intestinal pouch used in a catheterizable stoma to the urethra. As a result, the urine can eliminate without having an external opening. This is a complex reconstruction procedure and may lead to various complications such as scarring, internal urine leakage and incontinence.
Radiation
therapy
It is also called radiotherapy and uses high-energy rays to
kill cancer cells. It affects cancer cells only in the treated area. Radiation
may be given for small-muscle invasive bladder cancers. Some patients may
have radiation therapy before surgery to shrink the tumor and others may have
it after surgery to kill cancer cells that may remain in the area. The two types
of radiation therapy used to treat bladder cancer are :
External radiation : Radiation is produced by a machine outside the body. The machine targets a concentrated beam of radiation directly at the tumor area. This form of therapy is usually spread out in short treatments given 5 days a week for 5-7 weeks. Spreading it out this way helps protect the surrounding healthy tissues by lowering the dose of each treatment. Treatment may be shorter when external radiation is given along with radiation implants.
Internal radiation : A small pellet of a radioactive substance is placed inside the bladder through the urethra or by making a tiny incision in the lower abdominal wall. During the entire treatment, the patient must stay in the hospital. When the treatment is done, the pellet is removed. Once it is removed, no radioactivity is left in the body.
Side Effects : With external radiation, healthy tissue overlying or adjacent to the tumor can be damaged. The side effects of radiation depend on the dose and the area of the body where the radiation is targeted. Internal organs, bones, and other tissues can also be damaged. Common effects include extreme tiredness, vomiting, increased susceptibility to infections, hair loss, easy bruising or bleeding. Radiation therapy may cause decrease in the number of white blood cells. External radiation may permanently darken the skin in the treated area. Radiation to the pelvis may also cause nausea, diarrhea, urinary problems, and sexual problems such as vaginal dryness in women and erectile dysfunction in men.
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