When is Open Access Preferred?
Direct control allows you to accurately assess the boundaries of the tumor by palpation, excise the wall with adjacent tissues if it is suspected that it has gone beyond the bladder, perform reimplantation of the ureter with anti-reflux protection and reliably suture a large defect. For a urachus tumor, resection is complemented by removal of the urachus en bloc with the navel. Extended lymph node dissection removes nodes up to the aortic bifurcation. Catheter and drainage last 7–10 days, recovery 5–6 weeks; further observation - cystoscopy every 3 months.
When can you save the bubble?
Bladder resection is indicated for a single muscle-invasive tumor located away from the neck and triangle (dome, lateral walls, diverticulum, urachus tumor), without carcinoma in situ in the remaining mucosa and without a history of multiple recurrences. 5–10% of patients meet these criteria. If the indications are followed, the results are comparable to cystectomy, and bladder function and sexual function are preserved.
Observation
The remaining mucosa remains at risk of new tumors, so cystoscopy every 3 months in the first 2 years, urine cytology and MSCT are required; in case of relapse, TUR or cystectomy is performed. The capacity of the bladder after resection is restored within several months.
