Bladder cancer surgery decision criteria?

The Cleveland Clinic article that Sara Anne listed a few posts down is an excellent summary of pros and cons. my.clevelandclinic.org/health/articles/urinary-reconstruction-and-diversion

Ask away as many that monitor this board have had one of the 3 and possibly can answer better specific questions. The good news is you are choosing life and on your way to beating this!

Dave, I like your approach. I am also someone who wants all the facts before I make a decision. With all the research you have done, I assume you have found this link

my.clevelandclinic.org/health/articles/urinary-reconstruction-and-diversion

IMHO it is the best summary discussion of the various diversion types.

The answers to a lot of the questions which you have posed, however, are "it depends." It is possible to have any of the diversions and have minimal issues. It is also possible to have major problems after any of them. A lot depends on the skill of the surgeon. You want to have a surgeon who does MANY of the type that you hope to have. Five or ten a year is NOT a lot. You want someone who has done hundreds and has already run into the problems that come up. A lot of urologists tout the DaVinci device...which does robotic surgery so that the incisions are much smaller than with conventional surgery. IF you have a surgeon who is very experienced with robotic surgery, that is great. If he/she was taught by a salesman from the manufacturer, not so much (and believe me, that is how it is sometimes done). I have a urologist-friend who spent a year and a half at the Cleveland Clinic in an advanced fellowship to learn the technique. Bottom line...I would rather have traditional surgery than robotic with someone who is not EXPERIENCED. And it goes without saying, I would want traditional surgery with a very experienced surgeon also.

Of course you will discuss these issues with your surgeon candidates. How candid they are in their discussion would be another major factor in a choice both of surgeon and diversion.

Another major factor is the health and determination of the patient. If you are in good health other than the bladder cancer and are someone who can handle a totally new situation and the challenges it faces, you might be a good candidate for a neobladder. If you discourage easily, probably not.

I am sure that several others will chime in on this subject. I have NOT had to have a radical cystectomy, but know lots of people who have and have listened to a lot of their comments.

Wishing you all the best....

Sara Anne