Bladder and prostate cancer are among the most prevalent cancers affecting millions worldwide. Innovative treatments and surgical techniques have emerged, offering hope and improved outcomes for patients. One such intervention is cystoprostatectomy, a complex surgical procedure primarily used to treat cancer by removing the bladder and the prostate gland.
Cystoprostatectomy is a major surgical treatment that involves the removal of the bladder and the prostate gland. In some cases, additional structures, such as the seminal vesicles, part of the urethra, and nearby lymph nodes, may also be removed to ensure the thorough elimination of cancer cells. The surgery can be performed using traditional open methods or through minimally invasive approaches, including laparoscopic or robot-assisted techniques.
This procedure is typically recommended for men with muscle-invasive bladder cancer, where the cancer has grown into or through the muscle layer of the bladder. It may also be an option for those with high-grade, non-muscle invasive bladder cancer that has not responded to other treatments. Additionally, if prostate cancer coexists or if there is a significant risk of prostate cancer development, cystoprostatectomy becomes a viable treatment path.
Preparation for cystoprostatectomy involves several steps to ensure the patient is physically and mentally ready for the surgery. This includes comprehensive diagnostic tests such as blood tests, imaging studies (CT scans, MRI), and possibly a bone scan to assess the spread of cancer. Patients may also need to undergo bowel preparation and receive advice on quitting smoking and adjusting their medications. It's also essential for patients to discuss potential risks and complications with their surgeon.
Cystoprostatectomy typically requires general anesthesia and can take several hours to complete. The surgical approach chosen (open, laparoscopic, or robotic) will depend on various factors, including the surgeon's expertise, the patient's health status, and the extent of the cancer. After the removal of the bladder and prostate, surgeons must create a new way for urine to leave the body.
There are several options for urinary diversion, including:
Ileal Conduit: A small pouch is made from a piece of the intestine, which is connected to the ureters (tubes that carry urine from the kidneys). The other end is brought out to the abdominal wall, creating a stoma (opening) that urine can be expelled through.
Neobladder Reconstruction: A new bladder is constructed from a segment of the intestine, allowing the patient to urinate through the urethra in a more natural way.
Continent Urinary Reservoir: Similar to the ileal conduit, but with a valve mechanism created to control the flow of urine, requiring the patient to use a catheter to empty the pouch through the stoma.
Recovery from cystoprostatectomy can be challenging and requires time and patience. Hospital stays typically last from 5 to 10 days, followed by several weeks of recovery at home. Patients will need to learn how to care for their urinary diversion, manage pain, and recognize signs of complications. Follow-up care is crucial to monitor for cancer recurrence and manage any long-term effects of surgery.
Like any major surgery, cystoprostatectomy carries risks, including infection, bleeding, blood clots, and complications related to urinary diversion methods. There's also the potential impact on sexual function and fertility, which should be discussed with the healthcare team beforehand.
Cystoprostatectomy remains a vital component in the management of bladder and prostate cancers, offering a chance for cure or significant disease control in appropriately selected patients. Advancements in surgical techniques, particularly with minimally invasive and robot-assisted surgeries, have improved outcomes and reduced recovery times, making it a more feasible option for many patients.
Cystoprostatectomy is a complex but often life-saving surgical procedure for men with advanced bladder and prostate cancers. Understanding the process, from preparation through recovery, can help patients and their families navigate the challenges and make informed decisions about their care. For comprehensive prostate cancer treatment in India, American Oncology Institute is recognized as the top multi-disciplinary oncology hospital known for its expertise and advanced care.
