Bladder substitution following radical cystectomy for urothelial cancer (transitional cell carcinoma) has become increasingly common and in many centers has evolved to become the standard method of urinary diversion.
In determining the best type of urinary diversion for a specific patient, consideration must be given to both the morbidity associated with surgery and the potential positive impact on the patient's quality of life. Decision-making and perioperative care is ideally multidisciplinary, involving physicians and nurse specialists in urology, continence, and ostomy therapy. Physiotherapists may also be involved for pelvic floor muscle retraining. This article highlights preoperative considerations for patients undergoing radical cystectomy with a focus on issues specific to orthotopic bladder substitution as the method of urinary diversion. The second article in this 2-part series will outline postoperative strategies to manage these patients.
Written by:
Ong K, Herdiman O, Johnson L, Lawrentschuk N. Are you the author?
Austin Health, Urology Unit, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia; Austin Health, Urology Unit, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia; Continence Physiotherapist Eastern Continence and Pelvic Floor, Nth Ringwood, Victoria, Australia; Austin Health, Urology Unit, Department of Surgery, University of Melbourne, and Ludwig Institute for Cancer Research, Austin Health, Melbourne, Victoria, Australia.
Reference: J Wound Ostomy Continence Nurs. 2013 Jan;40(1):73-82.
doi: 10.1097/WON.0b013e31827759ea
PubMed Abstract
PMID: 23222970
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