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Your urinary system includes the kidneys, ureters, bladder and urethra. The urinary system removes waste from the body through urine. The kidneys are located toward the back of the upper abdomen. They filter waste and fluid from the blood and produce urine. Urine moves from the kidneys through narrow tubes to the bladder. These tubes are called the ureters. The bladder stores urine until it's time to urinate. Urine leaves the body through another small tube called the urethra.
The procedure to remove the entire bladder is called a radical cystectomy. In men, this typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy usually includes removal of the uterus, ovaries, fallopian tubes and part of the vagina.
After removing your bladder, your surgeon also needs to create a new way to store urine and have it leave your body. This is called urinary diversion. Your surgeon will discuss the options for urinary diversion that may be appropriate for you.
Your surgical team will talk with you about the type of urinary diversion you'll have. With urinary diversion, you have a new way for urine to be stored and exit the body after the bladder is removed. The goals of urinary diversion are to allow the safe storage and timely elimination of urine. Your doctors also will want to preserve your quality of life as best as possible.
Your surgeon removes the bladder from surrounding tissues. If the treatment is for bladder cancer, the surgeon will also remove nearby lymph nodes, which are part of the immune system. These will be looked at in a lab to see if cancer has spread to them.
In men, a radical cystectomy includes removal of the prostate and seminal vesicles. In women, it includes removal of the uterus, ovaries, fallopian tubes and part of the vagina. How much of the urethra is preserved depends on the type urinary diversion the surgeon will create.
For women, the removal of some vaginal tissue during surgery can make sexual stimulation or intercourse uncomfortable after surgery. Nerve damage also can affect arousal and ability to have an orgasm.
A lobectomy is a surgery to remove one of the lobes of the lungs. The lungshave sections called lobes. The right lung has 3 lobes. The left lung has 2lobes. A lobectomy may be done when a problem is found in just part of alung. The affected lobe is removed, and the remaining healthy lung tissuecan work as normal.
In most cases, during a lobectomy the cut (incision) is made at the levelof the affected lobe. The cut is most often made on the front of the chestunder the nipple and wraps around the back under the shoulder blade. Thesurgeon gets access to the chest cavity through the exposed ribs to removethe lobe.
At home, keep the cut clean and dry. Your healthcare provider will give youbathing instructions. The stitches or staples will be removed during afollow-up appointment. The cut may be sore for a few days. Your chest andshoulder muscles may ache, especially with deep breathing, coughing, andactivity. You can take pain medicine as advised by your healthcareprovider. Aspirin and some other pain medicines may increase bleeding. Makesure to take only the medicines your healthcare provider advises.
A common surgical approach to prostatectomy includes making a surgicalincision and removing the prostate gland (or part of it). This may beaccomplished with either of two methods, the retropubic or suprapubicincision (lower abdomen), or a perineum incision (through the skin betweenthe scrotum and the rectum).
Surgical removal includes a radical prostatectomy (RP), with either a retropubic or perineal approach. Radical prostatectomy is the removal of the entire prostate gland. Nerve-sparing surgical removal is important to preserve as much function as possible.
Transurethral resection of the prostate, or TURP, which also involves removal of part of the prostate gland, is an approach performed through the penis with an endoscope (small, flexible tube with a light and a lens on the end). This procedure doesn't cure prostate cancer but can remove the obstruction while the doctors plan for definitive treatment.
Radical prostatectomy with retropubic (suprapubic) approach. This is the most common surgical approach used by urologists (doctors who specialize in diseases and surgery of the urinary tract). If there's reason to believe the cancer has spread to the lymph nodes, the doctor will remove lymph nodes from around the prostate gland, in addition to the prostate gland. Cancer has spread beyond the prostate gland if it's found in the lymph nodes. If that's the case, then surgery may be discontinued, since it won't treat the cancer adequately. In this situation, additional treatments may be used.
Nerve-sparing prostatectomy approach. If the cancer is tangled with the nerves, it may not be possible to maintain the nerve function or structure. Sometimes nerves must be cut in order to remove the cancerous tissue. If both sides of the nerves are cut or removed, the man will be unable to have an erection. This won't improve over time (although there are interventions that may restore erectile function). If only one side of the bundle of nerves is cut or removed, the man may have less erectile function, but will possibly have some function left. If neither nerve bundle is disturbed during surgery, function may remain normal. However, it sometimes takes months after surgery to know whether a full recovery will occur. This is because the nerves are handled during surgery and may not function properly for a while after the procedure.
Radical prostatectomy with perineal approach. Radical perineal prostatectomy is used less frequently than the retropubic approach. This is because the nerves can't be spared as easily, nor can lymph nodes be removed by using this surgical technique. However, this procedure takes less time and may be an option if the nerve-sparing approach isn't needed. This approach is also appropriate if lymph node removal isn't required. Perineal prostatectomy may be used if other medical conditions rule out using a retropubic approach. With the retropubic approach, there is a smaller, hidden incision for an improved cosmetic effect. Also, major muscle groups are avoided. Therefore, there's generally less pain and recovery time.
The goal of radical prostatectomy is to remove all prostate cancer. RP isused when the cancer is believed to be confined to the prostate gland.During the procedure, the prostate gland and some tissue around the gland,including the seminal vesicles, are removed. The seminal vesicles are thetwo sacs that connect to the vas deferens (a tube running through thetesticles), and secrete semen.Other less common reasons for radical prostatectomy include:
Lymphedema. Lymphedema is a condition in which fluid accumulates in the soft tissues, resulting in swelling. Lymphedema may be caused by inflammation, obstruction, or removal of the lymph nodes during surgery. Although this complication is rare, if lymph nodes are removed during prostatectomy, fluid may accumulate in the legs or genital region over time. Pain and swelling result. Physical therapy is usually helpful in treating the effects of lymphedema. 2ff7e9595c
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