Bladder Cancer Treatment

(Muscle-invasive Bladder Cancer)

Muscle-invasive bladder cancer refers to cancer that has spread into the muscle wall of your bladder. Your doctor may recommend surgery to remove your bladder for this type of cancer or for bladder cancer that has returned. Surgery to remove the bladder is called a radical cystectomy.

What to Expect

Besides removing your bladder, surgeons may also need to remove lymph nodes and nearby organs if they contain cancer. In men, the nearby organs that may need to be removed are the prostate and seminal vesicles (glands that produce semen). In women, your surgeon may need to remove your uterus, ovaries and part of the vagina.

Your surgeon will also create a new channel for urine to pass from your body. Options may include a neobladder (new reservoir made of part of your intestine) an ostomy bag connected to your urethra through an opening (stoma) in your stomach. Depending on the surgical approach used, your surgeon may still need to create a stoma. You may also need to use a catheter to release urine several times a day.1

Even if your surgeon removes all of the cancer that can be seen during surgery, you may have to undergo chemotherapy to kill any cancer cells that could be left behind. In fact, research shows chemotherapy before or after a radical cystectomy may improve survival for men with muscle-invasive bladder cancer.2

Surgical options:

Open Surgery

Bladder cancer surgery is typically done using traditional open surgery. Open surgery, also called laparotomy, is any surgical procedure in which a large cut/incision is made to reach your organs. The incision must be large enough for your surgeon to fit his or her hands and surgical instruments inside your body. While open surgery allows your surgeon to see and touch your organs, it is invasive and can be traumatic on your body due to the large incision.

Minimally Invasive Surgery

Laparoscopic surgery is minimally invasive – meaning surgeons operate through a few small incisions. During traditional laparoscopy, long-handled surgical instruments are inserted through the incisions. One of the instruments is a laparoscope – a thin, lighted tube with a tiny camera at the end. The camera takes images inside your body and those images are sent to a video monitor to guide surgeons as they remove your bladder.

da Vinci® Surgery

With the da Vinci® Surgical System, surgeons operate through a few small incisions instead of a large incision used in open surgery - similar to traditional laparoscopy. The da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision, dexterity and control.

State-of-the-art da Vinci uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body.

  1. American Cancer Society. Detailed Guide: Bladder Cancer Surgery.
  2. American Society of Clinical Oncology. Bladder Cancer - Treatment.
  3. Yu HY, Hevelone ND, Lipsitz SR, Kowalczyk KJ, Nguyen PL, Choueiri TK, Kibel AS, Hu JC. Comparative Analysis of Outcomes and Costs Following Open Radical Cystectomy Versus Robot-Assisted Laparoscopic Radical Cystectomy: Results From the US Nationwide Inpatient Sample. Eur Urol. 2012 Jun;61(6):1239-44. Epub 2012 Mar 30.

All surgery presents risk, including da Vinci Surgery. Results, including cosmetic results, may vary. Serious complications may occur in any surgery, up to and including death. Examples of serious and life-threatening complications, which may require hospitalization, include injury to tissues or organs; bleeding; infection, and internal scarring that can cause long-lasting dysfunction or pain. Temporary pain or nerve injury has been linked to the inverted position often used during abdominal and pelvic surgery. Patients should understand that risks of surgery include potential for human error and potential for equipment failure. Risk specific to minimally invasive surgery may include: a longer operative time; the need to convert the procedure to an open approach; or the need for additional or larger incision sites. Converting the procedure to open could mean a longer operative time, long time under anesthesia, and could lead to increased complications. Research suggests that there may be an increased risk of incision-site hernia with single-incision surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant or morbidly obese are typically not candidates for minimally invasive surgery, including da Vinci Surgery. Other surgical approaches are available. Patients should review the risks associated with all surgical approaches. They should talk to their doctors about their surgical experience and to decide if da Vinci is right for them. For more complete information on surgical risks, safety and indications for use, please refer to

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