Name of the Procedure:

Cystotomy; Excision of Bladder Tumor
Common names: Bladder Tumor Removal Surgery, Cystectomy (partial), Surgical Bladder Tumor Excision

Summary

A cystotomy with excision of a bladder tumor involves surgically opening the bladder to remove a tumor. This procedure is done to eliminate malignant or benign growths from the bladder and can be performed using open surgery or minimally invasive techniques.

Purpose

Medical Condition: Bladder tumors, both malignant (cancerous) and benign (non-cancerous).
Goals: To remove the tumor from the bladder, alleviate symptoms, and reduce the risk of cancer spread or recurrence.

Indications

Symptoms: Blood in urine (hematuria), frequent urination, pain during urination, pelvic pain.
Patient Criteria: Diagnosed bladder tumors through imaging tests and/or cystoscopy, adequate general health to undergo surgery.

Preparation

• Fasting: Patients are typically required to fast for 8 hours before the procedure.
• Medication Adjustments: Blood thinners and certain other medications may need to be paused.
• Pre-procedure Tests: Blood tests, urinalysis, imaging tests (like a CT scan or MRI), and a cystoscopy.

Procedure Description

1. Anesthesia: General or regional anesthesia is administered.
2. Incision: A small incision is made in the lower abdomen to access the bladder.
3. Bladder Opening: The surgeon carefully opens the bladder.
4. Tumor Removal: The tumor is identified, excised, and removed. Tissue may be sent to pathology for analysis.

5. Closure: The bladder and abdominal incisions are sutured.

   Tools/Equipment:

   • Surgical scalpel, retractors, forceps
   • Endoscopic instruments for minimally invasive approaches

Duration

The procedure typically takes 1-3 hours, depending on the complexity and approach used.

Setting

Performed in a hospital operating room or a specialized surgical center.

Personnel

• Urologist or Surgeon
• Surgical Nurses
• Anesthesiologist
• Surgical Technicians

Risks and Complications

Common Risks: Bleeding, infection, blood clots.
Rare Risks: Bladder perforation, urinary incontinence, damage to surrounding organs, anesthesia-related complications.
Management: Infections are managed with antibiotics, bleeding may require transfusions, other complications are managed based on severity.

Benefits

• Primary Benefit: Removal of the tumor, which may alleviate symptoms and improve quality of life.
• Timeframe: Benefits are usually noticed shortly after recovery from surgery.

Recovery

• Post-procedure Care: Pain management, possible catheter placement for a few days.
• Instructions: Avoiding heavy lifting, drinking plenty of fluids, taking prescribed medications.
• Recovery Time: Typically 2-4 weeks, with follow-up appointments for monitoring.

Alternatives

• Other Options: Chemotherapy, radiation therapy, transurethral resection of bladder tumor (TURBT).
• Pros and Cons: Alternatives like TURBT are less invasive but may be less effective for larger tumors. Non-surgical treatments may prolong recovery but avoid surgical risks.

Patient Experience

During Procedure: Under anesthesia, the patient will not feel pain or be conscious.
Post-procedure: Some discomfort or pain at incision sites, which is managed with medication.
Follow-up: Patients may experience improved urination and relief of symptoms, with periodic follow-ups for monitoring bladder health.