Laparoscopy

There are two most common types of surgery on the bladder. There is endoscopic surgery in which surgery is performed through the urethra and is called TUR (transurethral resection), and then there is also non-endoscopic surgery in which the whole bladder (radical cystectomy) or part is removed (partial cystectomy). Non endoscopic surgeries can be performed laparoscopically, with the added benefits of less bleeding, better recovery and allows for a finer dissection which facilitates the preservation of nerves for erection and so a better chance of keeping a healthy sex life.

The most common reason to perform these surgeries is bladder tumours. Depending on the aggressiveness of the tumour, an endoscopic transurethral approach is used in less severe cases and laparoscopic techniques in more advanced cancers.

The surgery in which the bladder is removed (radical cystectomy) is usually associated with techniques in which a new “bladder” is created to collect the urine, usually using the intestine. This new bag may discharge through the skin (ileostomy or Bricker technique) or the urethra, which is the natural conduit for urine output (neobladder). Each of these options has its advantages and disadvantages, so every case should be evaluated to determine which technique will offer the best chance of curing the tumor and provide the best quality of life.

Although less frequent, other surgeries can be performed laparoscopically such as correcting urinary fistulas (urine output by other organs such as the vagina or intestine) or removal of bladder diverticula (areas of the bladder forming “bags” in wich the urine remains).