Urinary system including bladder, urethra, ureters and kidneys, which support stable chemical conditions in the body, and outputting the collected slag.
Bladder - a muscular organ that is located in the lower abdomen, and functions as a reservoir for urine. The kidneys filter blood and waste water removed in the urine. By ureters, two narrow tubes moves urine from the kidneys to the bladder. From it the other channel - urethra - it leaves the body. Female urethra passes through the vagina, for men - through the prostate gland and the penis.
Assuta Hospital - the largest private surgical center in Israel. Oncologic surgery in this country has reached a high level of development. Excellent results are achieved thanks to the skill and experience of the physician, the use of modern medical and engineering infrastructure.
Radical cystectomy (removal of the bladder cancer)
A surgical procedure in which the bladder is removed, called a radical cystectomy. Bladder cancer often spreads to other parts of the body.
Surgery to remove the bladder in men involves resection of the prostate, seminal vesicles and the surrounding lymph nodes. The consequence of surgery - abnormal ejaculation, but the ability to have an orgasm is not affected. Many men are experiencing problems with erection. This can be avoided if they saved the nerves that control penile erection. Then potency recovery occurs within a year. Alternative ways to achieve an erection, they need to discuss with the surgeon can be employed.
In women during cystectomy removed ovaries, fallopian tubes, uterus, cervix, vagina, and located next to the lymph nodes. When resection of the cervix and vagina segment may be difficult during intercourse in the first few months after surgery. During this time, vaginal tissue becomes longer, which improves sex.
Assuta Hospital doctors develop a personalized plan. For some patients, the best option - abdominal surgery, many - offer robotic laparoscopic surgery. When the recessed approach surgeon performs incision in the abdomen from the navel to the pubic bone. During robotic laparoscopic surgery, the doctor makes six short incisions, through which introduced laparoscopic ports. Through a small incision in the abdominal lymph nodes were removed and bladder, also make urine diversion in selected patients. Advantages of Robotic Laparoscopic Surgery:
- decrease of blood loss;
- a faster recovery of bowel function;
- reduction in hospitalization;
- early return to normal life.
Preparations for the removal of bladder cancer
The patient stays in the hospital the day of surgery. It advises the anesthesiologist. If the patient - candidate for epidural anesthesia after surgery, it will be organized on completion of the operation. This is a good option for pain management. Cystectomy bladder lasts 4-8 hours.
You may need to hold a series of tests - an electrocardiogram, chest X-ray, blood tests, and others.
Doctors recommend intake of probiotics - drugs containing the beneficial bacteria. This will reduce the risk of infection after the operation, improve the digestive system. It is important to start the reception two weeks before surgery.
Part of the intestine can be used to restore the urinary process. So you need to prepare the gastrointestinal tract before entering the clinic. Provide guidance to the patient. Prescribe two antibiotics - neomycin and erythromycin.
The task - to clear the body of solids. Start the procedure the day before surgery. Doctors provide recipes for the two antibiotics and GoLytely solution.
36 hours prior to cystectomy bladder can consume only clear liquids, to eliminate solid foods or dairy products. The diet may include:
- Clear broth.
- Coffee or tea (without milk or cream).
- Soft drinks.
- Jelly (not red or violet).
- Juices without pulp.
- Fruit icecream.
- Mineral water.
Colon Cleansing is performed using antibiotics and GoLYTELY. The stools become very watery. Cleanliness body is achieved when the chair becomes pale yellow liquid with no stains.
8 am - The patient begins to drink GoLYTELY, following the instructions for mixing. Drink one glass every 15 minutes. Drink a gallon a few hours.
13:00 - receives the first dose of antibiotics (neomycin and erythromycin). It is important to follow the instructions for dosage.
14:00 - receiving a second dose of antibiotics.
23:00 - the last dose of antibiotics.
After midnight, do not eat, fluid, and smoking. You can gargle but do not swallow the contents.
Medicines, the reception of which must be stopped 7-10 days prior to cystectomy:
- Vitamin E.
For 5-14 days is necessary to stop the use of the following medications:
The surgeon will provide specific instructions.
How can we improve nutrition before surgery?
Good nutrition - an important part of recovery. Doctors recommend trying to start a diet that includes drinks with a high protein content, to determine the appropriate taste. They offer after cystectomy to accelerate recovery. If you install a nutrient deficiency in the diagnosis, it is recommended to start drinking protein drinks and dietary supplements on a regular basis. It is important to know that after the operation the taste buds sometimes change temporarily, so you need to try something new in advance.
What should be taken to the hospital?
The patient may need the following things:
- Sweater or coat.
- Several sets of comfortable clothing (sweat pants, pajamas, underwear, socks).
- Personal items and toiletries.
- Glasses, dentures, hearing aids.
- Favorite pillow or blanket.
- Magazines, books and crossword puzzles.
- Favorite photos.
- Laptop, DVD.
- A list of important numbers.