Best Hospital

14 years 9 months ago #26094 by DoninRichmond
Replied by DoninRichmond on topic Best Hospital
:) Thanks folks for your kindness and detailed info. Should the need arise, my first choice will be John Hopkins Hosp.

God Bless

Bill Jr
Tumor removed 5/4/09
\"T1 high-grade\"
Started \"BCG\" 5/21/09
Have a 2-yr treatment schedule

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14 years 9 months ago #26090 by Patricia
Replied by Patricia on topic Best Hospital
No Britt...success in this meaning a thoroughly functioning neobladder...no hyper or hypocontinence. It happens more with females than males...thats all i was referring to. And most females with the neo that have complications figure it out eventually and don't mind cathing....those that have continual UTI's sometimes convert to an ileal conduit just so they don't have to run to the bathroom all day and all night long.
Having your bladder replaced just seems like a horrible thing...in truth after 6 l/2 yrs with an Indiana Pouch i wonder why it wasn't put there in the first place?? I had a Great surgeon...no scars...my stoma is where my navel was so if i would want to wear a bikini you would not notice anything unusual about me other than i'd have to be pretty nervy at my age to wear a bikini!
Pat:S

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14 years 9 months ago #26089 by mmc
Replied by mmc on topic Best Hospital
I'll let Pat answer for herself, but usually we are talking about dissatifaction with the urinary diversion due to complications of one kind or another (e.g. chronic incontenence, hypercontinence, etc.).

From my perspective, I can tell you it is lot less scary after you have the bladder out.

See my recent thread www.bladdercancersupport.org/index.php?option=com_kunena&Itemid=114&func=view&catid=5&id=26055 if you haven't already. Some info from those of us who have had our bladders removed.

Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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14 years 9 months ago #26087 by britt
Replied by britt on topic Best Hospital
Pat, what does the "succes rate" mean? If its not a success does the patient die? Or just have to live with terrible complications? The though of having ones entire bladder removed is a scary thought!

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14 years 9 months ago #26086 by Patricia
Replied by Patricia on topic Best Hospital
Well its a pretty hot topic among uro's and they're trying to get it right which is why they probably keep telling women to get them even though success rate is around 33% as compared to 90% with men.
www.urotoday.com/3391/urotoday_international_journal/female_urology/hypercontinence_in_women_after_

Introduction: There is a great debate about the cause of the higher incidence of hypercontinence in women undergoing orthotopic diversion after cystectomy in relation to men.



Conclusion: The relaxation of the striated sphincter and the contraction of the longitudinal smooth muscle opens the way for micturition. The loss of this normal coordinated reflex leads to the presence of a urethra with a fixed tone that does not open with trials of evacuation. As men and women have an intact striated sphincter, the higher incidence of hypercontinence in females compared to males is due to the presence of the extra tone of the urethral smooth muscles. This study proves that the more urethral length left, the higher the incidence of hypercontinence because more smooth muscle tone is faced during micturition. Nerve preservation has no impact because the coordinated detrusor urethral smooth muscle action is lost.

Pat

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14 years 9 months ago #26085 by reseda1420
Replied by reseda1420 on topic Best Hospital
Still, that shouldn't presuppose a neo can't be done unless there are other factors we're not aware of.

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