Surgery to Create an Artificial Bladder From the Intestine

An artificial bladder is the procedure of making a new bladder from the patient's own small intestine in place of the bladder after it has been removed in the treatment of bladder cancer.

When the cancerous bladder is removed with bladder cancer surgery, that is cystectomy, the patient needs a bladder in order to be able to pass urine. This bladder-making procedure is carried out by specialist doctors with a piece taken from the patient's own intestine.

What Is an Artificial Bladder?

In some types of urinary bladder cancer, the only treatment option for the cancer is removal of the bladder. In place of the removed bladder, a new bladder is made by the method of creating a bladder from the intestine.

If bladder cancer affects the muscle layer of the bladder, or if there are numerous large tumours that have come very close to the muscle layer, the likelihood of the cancer metastasising is very high. This is an extremely dangerous situation for the patient's life. The treatment of this situation is the operation known in urology as "radical cystectomy", in which the bladder, prostate, seminal vesicles and the lymph tissues around the large vessels are removed.

Creating an Artificial Bladder

When a new bladder is made from the intestine, a 50 cm long piece is taken from the intestines. This piece taken is folded over on itself several times and brought into a spherical shape so that its form and functions resemble the bladder and it can carry out its duties.

In this way its internal volume is expanded so that it can store urine. Two ureters are connected to one end of this artificial bladder that has been brought into a spherical shape. Its other end is connected to the external urinary channel.

The Advantages of the Artificial Bladder

The artificial bladder made from the intestine provides many advantages. Among some of the treatment options applied after cystectomy, creating an artificial bladder is among the most frequently preferred methods.

• It is socially acceptable.
• Whereas the probability of the cancer recurring in the postoperative period is 11.2% in the method with a bag fitted, it is around 2.8% in the artificial bladder method made from the intestine.
• The artificial bladder has no particular lifespan. As long as the patient continues their life, they experience no problem at all relating to the artificial bladder.

How Do Patients Pass Urine After the Bladder Has Been Removed?

In urology there are many methods as a solution to this problem. The most frequently used method among these is the method called "ILEAL CONDUIT", in which the two ureters are connected to one end of a 12-15 cm thin piece of intestine and the other end of the piece of intestine is connected to the skin of the abdomen. The urine coming from the ureters into this piece of intestine fills a bag stuck to the patient's skin, and as this bag fills up patients empty the bag. On average this bag stuck to the skin needs to be changed every 2-3 days.

A type of treatment has been found as an alternative to this old method used. This method is the artificial bladder creation method called "ORTHOTOPIC BLADDER", which has also been actively used in our country for the last 12-13 years. In this method the small or large intestine, or both together, can be used.