Choice of a method of surgical treatment of urinary bladder cancer

Abstract

The results of treatment of 850 patients with urinary bladder cancer (UBC) are analysed. Precise staging of the tumor should be made in the following order: suprapubic ultrasonic investigation (USI), cystoscopy and microcystoscopy, transrectal, transurethral USI. Indications for different treatments are outlined: typical and atypical papillary fibroepithelioma, papillary cancer in stage Tl should be managed with TUR after previous electrocoagulation; cancer in stage T23 - with urinary bladder resection and uni- or bilateral pelvic lymphadenectomy; total papillomatosis, multiple lesions in stage T3, in cases of recurrent cancer -with cystectomy including one-stage or multistage replacement of the urinary bladder by intestinal transplant. The only physiologically sound method of treating patients after cystectomy with ureterocutaneostomy and ureterocolostomy is creation of intraperitoneal intestinal urinary bladder with reestablishment of transurethral urination. Arguments against creation of artificial urinary bladder made of detubularized segments consist in the absence of advantages.