Dr. Xie showed the CT image of the artificial new bladder reconstructed by small intestine. (Photo courtesy of Taichung Tzu Chi Hospital) Xie, a urologist in Taichung Tzu Chi, said that if the second stage bladder cancer has not yet metastasized from the bladder, according to the treatment guidelines, total cystectomy is needed to ensure that the cancer cells will not spread. Although the operation itself is not difficult, in the traditional operation, it is necessary to pull 15 ~ 20 cm intestine out of the body, and then connect the urine bag through abdominal stoma to replace the original bladder function.
This new type of cystectomy combined with orthotopic artificial bladder reconstruction can reconstruct a new bladder with small intestine. (Photo courtesy of Taichung Tzu Chi Hospital) However, Dr. Xie pointed out that the new operation of "cystectomy combined with in-situ artificial bladder reconstruction" can improve the appearance and quality of life problems brought by traditional surgery. During the operation, it is necessary to remove the whole bladder first, then sew a small intestine about 80 cm into a bladder-like shape, and then connect the ureter and urethra of the kidney. Because the reconstruction process is very complicated, the operation time of 12 hour is 4 hours longer than that of traditional operation, so whether the patient's physical strength can be loaded is also the focus of preoperative consideration.
Fortunately, although Mr. Huang is over 60 years old, he has been running marathons for many years and has maintained a good physical fitness. Therefore, the doctor judged that this artificial bladder reconstruction operation was appropriate. Three months after operation, the patient recovered through catheterization training. The urine in the new bladder has exceeded 400 ml and has returned to the same volume as the original bladder.
Dr. Xie Fu Deng explained that because the bladder reconstructed by intestinal tract has no nerve, it won't produce the feeling of urination. Patients must undergo "urethral catheterization training and rehabilitation" after operation, and they should conduct urethral catheterization by themselves every few hours, especially before going to bed, so as to avoid intestinal mucus and stones, which will cause infection over time. In addition, as long as patients drink plenty of water to help eliminate intestinal mucus, and then cooperate with catheterization, regular follow-up, moderate exercise, and eat more fresh fruits and vegetables, the new bladder can be used for a lifetime.