Urinary Bladder

Personally performed operations (as of 2019) : 1166

Surgery of the urinary bladder is usually necessary to treat cancer of the bladder. Depending on the stage of the tumor, different operational techniques are used. Carcinomas of the urinary bladder, which are yet limited to its mucosa, can be completely removed through the urethra, using a method called transurethral resection (TUR-bladder). If the cancer has infested a larger part of the bladder, or has spread to its muscles, a so-called radical cystectomy can become necessary. In its course, the whole bladder, the prostate/uterus and the surrounding lymph nodes are removed. This operation can also be performed laparoscopically, using the Da Vinci Surgical System, as long as the tumor has not infiltrated surrounding organs or metastasised to other lymph nodes.

The bladder replacement is of crucial importance to the preservation of the patients quality of life. There are different methods to approach this. Ideally, a replacement can be formed, using the small intestine and connecting it to the ureter (so-called ileum neo-bladder or Studer bladder) which allows for a natural way of draining through the ureter. If the ureter cannot be preserved, there is the possibility of creating a continent reservoir from small intestine and colon (so-called MAINZ-Pouch I), which the patient can empty himself/herself with regular catheterisation. The so-called ileum conduit is an artificial bladder exit in the skin, through which the urine is transported to the outside and captured in a colostomy bag.