Bladder-related problems can take a hit to one’s self-esteem and confidence, especially if incontinence is a symptom. Serious problems like bladder cancer can be scary to go through as well. Bladder surgery is necessary for some conditions if other treatment methods haven’t worked. Continue reading to learn more about this type of surgery, the risks involved, and possible alternatives to surgery.
What Is Bladder Surgery?
Bladder surgery is the repair of the bladder through surgical means. In some cases, the bladder needs to be removed. In its place, surgeons reconstruct the bladder with intestinal tissue. Doctors sometimes recommend bladder surgery for urinary incontinence, bladder cancer, and cystocele. There are different types of bladder surgery, so the procedure one goes through depends on the type of surgery.
If a new bladder is needed, surgeons will remove a segment of the intestines and create a “bladder” from it and attach it to the ureters. The ureters are a duct through which urine travels from the kidneys to the bladder, or new bladder in this case. This bladder varies in size from a small pouch to the size of an original bladder. Many patients prefer this option because it allows the urine to exit their bodies in a way they’re used to rather than having to empty a bag. The other option is a leak proof bag that is connected to a tube, known as a stoma”, and brought to the skin for collecting the urine. Patients can empty the bag as needed.
Types of Bladder Surgery
- Bladder Suspension Surgery . A prolapsing, dropping, or sagging bladder is returned to its correct position. It treats stress incontinence, which is urine leakage when a person coughs, sneezes, or laughs. There are several ways to perform bladder suspension surgery. The surgeon may make incisions in the abdomen and pull up the bladder neck. To keep the bladder neck in place, they sew the bladder neck to surrounding tissue or bone. A newer more common method is to use a sling or hammock-like structure to support the bladder neck. The structure can be made out of body tissue or man-made materials such as polypropylene.
- Transurethral Resection with Fulguration. A thin lighted tube called a cystoscope is inserted through the urethra to the bladder. While inside the bladder, surgeons use a tool with a small wire loop to burn away cancer formations. It’s effective on tumors as well.
- Segmental Cystectomy. Part of the bladder is removed in segmental cystecomy. It can be performed in some instances of bladder cancer invading the muscle wall. As long as the cancer is only in one part of the bladder, segmental cystectomy is an option.
- Radical Cystectomy. If bladder cancer has spread to the muscle wall or inflicts a large part of the bladder, the patient may undergo radical cystectomy. In this surgical procedure, the surgeon removes the bladder and any lymph nodes or organs that contain cancer.
When Do You Need Bladder Surgery?
- Bladder Cancer. In some instances of bladder cancer, a doctor may determine that surgery is the best option for curing it. It’s only in severe cases that doctors recommend removing part or all of the bladder. The goal is to keep the bladder in tact while getting rid of the cancer. Surgery can also be used to diagnose bladder cancer. Transurethral bladder tumor resection can be used to diagnose and stage bladder cancer.
- Urinary Incontinence. Having urinary incontinence usually affects a person’s self-esteem and causes embarrassment. Urinary incontinence can be caused by childbirth, chronic lifting, genetics, menopause, and surgery. Patients report some of the best benefits of surgery for urinary incontinence is the restoration of one’s self-esteem and security in social situations. Surgery should only be considered if other treatment options for this condition have failed.
- Cystocele. Also called fallen bladder, cystocele occurs when the bladder bulges into the vagina. It can cause a feeling of pressure in the pelvis and vagina and discomfort when straining. Mild cases of cystocele may be corrected by Pelvic Floor Physical Therapy and Behavior modification techniques. Moderate to severe instances of cystocele will require surgery or the placement of a pessary to lift the bladder.
- Hematuria. Women and men who suffer from hematuria can sometimes solve the problem through bladder surgery. Hematuria is when there is blood in your urine. The source of the blood can be the bladder, ureters, or kidneys. Those who have moderate to severe hematuria that keeps coming back can consider surgery as a possible treatment. The blood isn’t always visible. Sometimes a doctor will find microscopic blood in a urine sample, indicating the patient has hematuria.
Risks Involving Bladder Surgery
- Kidney infection.
- Bowel obstruction.
- Leaking urine or stool.
- Renal failure.
- Strictures – Scar tissue inside the bladder, ureters, or intestines.
- Obstruction of the intestines or ureters.
- Blood clots in the lungs or legs.
- Infection at the surgery site.
- Damage to organs near the bladder.
- Some forms of bladder surgery, due to a cancer for example, make the patient infertile because reproductive organs may be removed in the process.
- If men had their prostate and seminal vesicles removed during surgery, then they may experience erection problems.
- Women who have part of their vagina removed during surgery may experience sex problems.
Recovery takes several weeks for women who receive bladder surgery for urinary incontinence. You may have to temporarily use a urinary catheter while healing. How long it takes to recover depends on the individual. Your doctor will let you know expected recovery time. It can take up to six weeks for women to be able to resume sexual activity after surgery for urinary incontinence. And it takes around 2-6 weeks until being able to safely lift heavy objects or exercise strenuously.
Recovery time can take up to several months, depending on what type of surgery a patient undergoes. After surgery, the doctor will test how well they’re able to hold urine to guide them through recovery. If self catheterization is needed, the doctor will explain how to use and take care of the catheter.
On average, it takes one to three hours to complete the surgery, depending on the type. You may be required to stay overnight. During recovery, women shouldn’t wear tampons or use douches for six weeks to allow the sutures in the pelvis to heal and minimize the risk of infection. Both genders should avoid intercourse for six weeks. Patients are also advised to not strain during bowel movements during recovery. Doctors will prescribe pain medications to relieve pain or discomfort after surgery.
Alternatives to Bladder Surgery
Possible alternatives to bladder surgery include Kegel exercises, radiation therapy, immunotherapy, and chemotherapy:
- Kegel exercises can cure urinary incontinence by strengthening the pelvic floor. They are easy to do at home.
- Radiation therapy can be used to kill cancer cells via high energy X-Rays or other particles.
- Immunotherapy utilizes materials from the body or a laboratory to boost one’s ability to fight off the cancer.
- Chemotherapy is one of the most well-known cancer treatments. It uses drugs to stop cancer cells from growing and dividing.
Bladder surgery can be used to treat bladder cancer, urinary incontinence, cystocele, hematuria, and other types of bladder problems. Before turning to surgery, one should explore all possible options for treatment. Some people don’t need surgery to overcome a health issue. If you suspect you may need surgery or want further information, please contact a medical professional.
Have you had a surgical procedure performed for a bladder problem before? Were there any complications? Let us know in the comments below.
IMAGE SOURCE: Deposit Photos