The management of bladder tumors is based on two major interventions, the risks of complications of which can be significant. The objective of this work is to provide an update on the complications related to bladder surgery, to detail the preventive measures and management strategies in practice.
Bibliographic search using Medline bibliographic database (Pubmed) using the following keywords: transurethral resection of the bladder, cystectomy, neobladder, Bricker, complications, anastomotic strictures.
Trans-urethral resection of the bladder (TURB) essentially exposes to the risk of hemorrhage (2 to 4%) and bladder perforation (1 to 3%). Total cystectomy is associated with significant morbidity and mortality, despite recent technical advances. The most frequent early complications are ileus (23 to 30%) and infectious complications (29 to 38%). Late complications included by functional complications (urinary and sexual), anastomotic strictures (7 to 12%), metabolic complications of continent derivation (25 to 46%) and stomial complications in case of non-continent derivation. The management of complications is well codified. It is however essential to anticipate and put in place preventive measures, especially for infectious and thromboembolic complications, including an exhaustive pre-operative assessment, prehabilitation of the patient and enhanced recovery after surgery.
Preventing, analyzing and understanding complications in bladder surgery is essential to reduce mortality and morbidity.
Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie. 2022 Nov [Epub]
G Pignot, D Legeais, K Bensalah, R Mathieu, F-X Madec, C Lebacle, S Doizi, V Phe, J Irani
Service de chirurgie oncologique 2, Institut Paoli-Calmettes, 13009 Marseille, France. Electronic address: ., Clinique d'Alembert, 38000 Grenoble, France., Service d'urologie, hôpital Pontchaillou, CHU de Rennes, 35033 Rennes, France., Service d'urologie, hôpital Foch, Université de Versailles - Saint-Quentin-en-Yvelines, 92150 Suresnes, France., Service d'urologie, Hôpital de Bicêtre, AP-HP, Université Paris Saclay, 94270 Le Kremlin-Bicêtre, France., Service d'urologie, Hôpital Tenon, AP-HP, Sorbonne Université, 75020 Paris, France.