In some cases, the samples obtained during the first TURB (biopsy) have all the tissue necessary for a diagnosis. Sometimes they do not and good medical practice would lead the urologist to do a second biopsy. The need for a second biopsy does NOT indicate that the urologist was not competent...rather that heshe is following the best recommended procedures. In fact, some recommend a second biopsy in all cases.
And yes, it is important for ANY medical procedure to have it done at the very best place possible.
IF it comes to a bladder removal, there are three main types of surgery. The simplest is where the bladder is removed and the urine is routed through an exit in the abdomen and into an exterior bag. The second uses a piece of the bowel to form a new "bladder" where the urine collects inside the body. There is an exit or stoma placed in the abdomen and the patient uses a catheter to remove the urine. This is often called an "Indiana Pouch." The third is the neobladder, where a new bladder is constructed from a piece of the bowel and hooked up to the original "plumbing." When it works, it is almost like a normal bladder. It is usually not used in older patients due to the complexity of the surgery and the recover.
Alan has a reference which I am sure he may post that describes the procedures in more detail. (ALAN, I LOST THE REFERENCE AGAIN) But, right now you need to concentrate on getting a thorough diagnosis and recommendation from a really good center. It is likely that he will not even need to consider bladder replacement.
Sara Anne