The patient's analysis and evaluation of choice of supravesical urinary diversion in patients subjected to radical cystectomy due to invasive bladder cancer
Article published in Urologia Polska 2006/59/4.

authors

Krzysztof Bar, Jerzy Michalak, Dariusz Borowiec, Radosław Starownik, Robert Klijer, Waldemar Białek: Katedra i Klinika Urologii i Onkologii Urologicznej Akademii Medycznej w Lublinie

keywords

urinary bladder, bladder cancer, radical cystectomy, ileal conduit

summary

Introduction. The problem of urinary diversion is integrally associated with radical cystec-tomy in patients with muscle invasive bladder cancer.

The aim of the study. The authors analyzed retrospectively the conditions of supravesical urinary diversion choice in patients subjected to radical cystectomy due to invasive bladder cancer.

Material and method. There were 62 radical cystectomies performed due to advanced cancer of urinary bladder from October 2000 till June 2005. In 52 patients (83.9%) ileal conduit was applied as urinary diversion.

Results. Radical therapy in almost half of the patients (43.5%) has been introduced in the period of 1 to 6 months (4.1 month average) since the first symptoms occurance. Histological evaluation of surgical specimens showed ca uroepitheliale in 55 (88.8%) patients. In 18 (29%), 17 (27.5%) and 20 (32.3%) of them, pathological stage and grade were - T2G1-3 , T3G1-3 and T4G2-3 respectively. Other tumors occured in 7 cases (11.2%). Metastases to the lymphatic nodes were found in 17 (21,0%) patients and the presence of tumour infiltration beyond the bladder in 37 (59.7%) patients.

Conclusions. 1. The average period which went by from occurance of first symptoms of bladder cancer to carry out the radical cystectomy was 4,1 month in patients from municipal centres and as much as 43,6 months from country-sides. 2. Stage of the tumour as well as the patient's state of mind (the lack of co-operation and understanding of low-pressure intestinal bladder) were the cause of choice of the kind of urinary diversion.

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