Oncology

Especially painless hematuria with clots in it, is an absolute indication for futher work up for a possible diagnosis of bladder cancer. Male sex, age and cigarette smoking are important risk factors. Diagnosis is done by simple ultrasound or endoscopy(cystoscopy). If the cancer is superficial, transurethral endoscopic surgery is enough for treatment( if the disease does not have high risk characteristics). Sometimes we give intracaviter instillaton treatments to postpone or stop the recurrence of the disase, since bladder cancer may recur. If the disease has invaded into the deep layers of the bladder, then a radical cystectomy is inevitable. We can use different techniques for diversion of the urine drainage, like cutanous ileal-loop diversions, or forming a neobladder out of ileal intestinal segments which is contiuous with the urethra, so that the patient has the chance to keep continent and dry. All these choices should be discussed with patient by an expert in this field.