Cystectomy+Urinary Diversion

If the surgery is performed for a bladder tumor, the bladder, prostate, seminal sacs and lymph nodes in men and the uterus, ovaries and anterior 2/3 vaginal wall in women are removed through a 30-35 cm incision in the upper and lower abdomen under general anesthesia. Lymph nodes are routinely removed and, together with the bladder, sent for pathologic evaluation to determine the stage of the cancer. In bladder removal due to neurogenic bladder, enterovesical or vesicovaginal fistula or trauma, only the bladder is removed. After the bladder is removed, a 15-20 cm section of the small intestine is removed and used to create a new bladder. Depending on the situation (stage of the disease, age, general condition of the patient, need for additional treatment, etc.), the new bladder made from the intestine is implanted into the skin on the right side of the belly in the abdomen or the old bladder is replaced and re-anastomosed to the urethra. If urinary diversion is performed by replacing the old bladder with a new bladder, the patient can urinate normally in this type of diversion (orthotopic urinary diversion). If the new bladder is mouth to the skin, a bag and valve system will be attached to the mouth and the urine will be discharged involuntarily into the existing bag or in the presence of continent diversion (allowing urine retention), the patient will be able to empty the urine 4-6 times a day by inserting a catheter through the hole in the skin. At the end of the operation, 2 drains are placed in the new bladder and 2 drains are placed in the abdomen where the bladder exits. In case of orthotopic bladder, 1 urethral catheter is also placed. Vasectomy is done routinely.