In the last article, we have the treatment (therapy) of already infiltrated (have penetrated into the bladder) urinary bladder tumors and their urinary diversion after bladder removal explained. Since this issue has not yet been fully realized, we sat in this edition continues this product with other surgical and non surgical treatment forms of infiltrating bladder cancer.
First, the neobladder, which forms a reservoir for the urine using off small intestine and is drained naturally through the urethra has been developed just for men. Before 1980, there were in terms of anesthesia, intensive care and infection prophylaxis is no way, in a surgical procedure to remove the bladder and at the same time make a neobladder from the small intestine as Harnableitungssystem, without running the risk of losing the patient during surgery , Only after that there was the possibility of new processes orthotopic neobladder a (bladder replacement) manufacture of small bowel loops and 1986 there was the first opinions on this method, which has since found more often than standard Harnableitungssystem use worldwide. The risks of surgery are nowadays regarded as low.
The small intestine replacement bladder (neobladder) comes for their seat in the basin and the connection to the existing urethra natural urinary diversion closest. Emptying by abdominal pressure on natural way.
However, in order to attain a satisfactory continence after the surgery, it requires a competent follow-up, where not only the complete emptying of the neobladder, but also keeping the urine must be learned using the remaining lower sphincter and the pelvic floor. The individual instruction and the consequent training of the affected muscle groups in this case forms the basis for a rapid rehabilitation.
For several years, the neobladder has also brought significant benefits for women after new surgical techniques have been developed, and the complication rate could be significantly reduced.So today, for example, supporting tissue sections or titanium-coated mesh implant to be used, which are to prevent the sagging of the neobladder in the rear pelvic area and thus a bending and the resulting closure of the urethra.
Press relation from Detlef Höwing