Bladder Surgery
Bladder surgery is a treatment option for patients suffering from bladder cancer or incontinence. Tumors can put pressure on the urethra and prevent urine flow. Bladder surgery helps remove cancerous tissue and restore bladder health in cancer patients. Bladder surgery can also help restore normal urinary functions.
There are four major options for bladder surgery: retropubic suspension, urethral sling procedure, removing bladder stones, and artificial urinary sphincter.
Retropubic suspension
Retropubic suspension is a bladder surgery used to treat women with incontinence by lifting the sagging bladder and urethra. These structures have dropped abnormally low in the pelvic area and need to be returned to their normal position. An incision is made into the abdomen to access the bladder and lift it off the urethra. A catheter is placed into the bladder through the urethra to aid urine drainage.
Urethral sling procedure.
The urethral sling procedure is another bladder surgery option for women. A sling is placed around the urethra to return it to its natural position. The sling also adds pressure to prevent accidental urine leakage. It is attached to the abdominal wall and is made of either synthetic material or organic tissue. A plastic sling is compatible with the body and will be absorbed and disintegrate eventually. Patients undergoing the sling procedure share the same recovery period and similar complications as patients treated with retropubic suspension. In addition, obese patients have a higher risk of stitches pulling free. Also, a synthetic sling may irritate the urethra or vagina and cause sexual dysfunction.
Bladder stones
Bladder stones are smell masses of minerals that form in your bladder.Bladder stones develop when urine in your bladder becomes cocncetrated causing minerals in your bladder. Some bladder stones can block the flow of urine and will need to be removed. Small bladder stones may pass on their own, but some bladder stones are more common in men. A telescopic tube called a cystoscope is inserted through your urethra and into the bladder to view the bladder stones. Bladder stones are crushed by ultrasonic waves, hammering, or electrohydraulic sparks and removed through the cystoscope. Occasionally, you may need bladder surgery to remove bladder stones that are large or too hard to fragment are removed through open surgery. In cases of unusually large bladder stones or enlarged prostate, a procedure called suprapubic cystostomy is performed to create a connection from the bladder to the skin to bypass the urine blockage. A catheter is placed through the connection to drain the urine. The catheter needs to be replaced every 4-10 weeks. A bag outside the body collects the urine. Bleeding and infection are possible complications.
Artificial urinary sphincters
Another bladder surgery is artificial urinary sphincter implants. It restores normal urinary function to patients with weakened sphincter muscles. Involuntary urine leakage occurs when the sphincter is too weak to hold urine in the body. The artificial sphincter is composed of three parts: an inflatable cuff that applies pressure on the urethra to hold back urine, a balloon that controls the pressure applied by the cuff, and a control pump that inflates and deflates the cuff by regulating the flow of fluid between the cuff and balloon. An incision is made in the scrotum, labia, or lower belly to insert the device. The balloon sits under the belly muscles. The pump is placed either in the scrotum in men or underneath the skin of the lower belly or leg of women. Patients risk bleeding and the deterioration of surrounding tissues due to constant mechanical manipulation of the device.