Examination of the urinary bladder with a telescope inserted through the urethra. The cystoscope also allows diagnostic evaluation and treatment of some conditions of the urinary tract.
Suprapubic Tube insertion
If it is functioning improperly, insertion of a catheter through the abdominal wall directly into the bladder may be necessary to help with bladder management.
Management of Overactive Bladder
Urinary frequency and urgency can sometimes be controlled with medication and other conservative measures. At times, if medications are not effective, further intervention may be necessary. This may include injection of Botox into the bladder, or insertion of a ‘pacemaker’ for the bladder.
Some bladder injuries can be managed conservatively with a catheter. Other injuries, depending on location, may require surgical repair.
Transurethral resection of bladder tumor
Using a telescope inserted through the urethra to evaluate the bladder and ‘shave out’ a mass or suspected tumor.
Simple Cystectomy or Partial Cystectomy
Sometimes a portion or whole bladder may be removed for benign (non-cancerous conditions) or in certain settings of cancer.
Radical Cystectomy with pelvic lymph node dissection
Removal of the entire bladder for more aggressive bladder cancer, as well as removal of the lymph nodes in the pelvis where cancer can spread.
Creation of a way to pass urine if the bladder must be removed or in some cases where the urinary bladder not functioning properly. Urinary diversion may include ileal conduit (using a segment of intestine to create a passage for urine) or continent urinary diversions (including a neobladder or Indiana Pouch).
Vesicovaginal Fistula Repair
A fistula is an abnormal connection between two adjacent structures, in this case the bladder and vagina. These may occur as a result of injury, radiation, or a local disease process, and surgery may be necessary for repair.
Colovesical Fistula Repair
A fistula is an abnormal connection between two adjacent structures, in this case the colon and bladder. These may occur as a result of injury, radiation, or a local disease process, and surgery may be necessary for repair.
Management of Bladder Neck Contracture
The bladder neck is the outlet where urine leaves. This area can become scarred after surgeries to remove the prostate (for cancer, or for BPH), or after radiation. Treatment of this scar tissue may be endoscopic (with a telescope through the urethra), or in select cases with formal open surgery to remove the scar tissue.
Intravesical therapies for Bladder Cancer
Some bladder cancers can be treated by instilling an agent (immunotherapy or chemotherapy) directly into the bladder.
Management of Neurogenic Bladder
Sometimes the nerve connections from the brain to the bladder do not function properly, in cases such as spinal cord injury and in other neurological disorders. Poor bladder function can cause many problems and needs management that may include medications, catheter use, and sometimes surgery.