Friday, April 13, 2012

Radical cystectomy and urinary diversion


Radical cystectomy and urinary diversion

Indications
1- Traditionally radical cystectomy is recommended for patients with muscle-invasive bladder cancer T2-T4a, N0-Nx, M0.

2- Other indications:
A- High-risk and recurrent superficial tumours, BCG-resistant Tis, T1G3, as well as extensive papillary disease that cannot be controlled with TUR and intravesical therapy alone.

B- Salvage cystectomy
* Non-responders to conservative therapy
* Recurrences after bladder sparing treatments
* Non-urothelial carcinomas (these tumours respond poorly to chemo- and radiotherapy)
* Purely palliative intervention for e.g. fistula formation, pain or recurrent macrohaematuria.

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