Bladder Cancer Surgery & Procedures

Houston Methodist’s specialists treat bladder cancer from early-stage to advanced disease. We use innovative diagnostic and surveillance tools and perform minimally invasive robotic bladder cancer procedures, including robotic-assisted radical cystectomy.

With multiple locations across Houston, we offer expert care close to home or work.

Our Approach to Bladder Cancer Treatment

Our experts are among the best nationwide in treating bladder cancer, and we are one of just a few centers that perform entire bladder removals and urinary reconstructions completely robotically. We also offer access to clinical trials that offer potentially promising bladder cancer treatments not available to the general public.

We specialize in advanced bladder cancer, and our minimally invasive approaches decrease pain and complications, so you can recover more quickly. Our specialists use enhanced recovery techniques to reduce pain and complications, allowing you to get back to work and activities sooner.

Bladder Cancer Treatment & Surgery Options We Offer

Once bladder cancer has been diagnosed and staged, your doctor may recommend one or more of the following treatments:

Bladder Cancer Surgery

Bladder cancer treatment plans often include one of the following surgical procedures:

• Transurethral resection of bladder tumor (TURBT) – used for early-stage bladder cancer or precancerous abnormalities. A resectoscope, a thin tool with a wire loop on the end, is threaded through the urethra to the bladder and used to remove the tumor from the bladder wall.
• Partial cystectomy – removal of the tumor and part of the bladder. While this procedure eliminates the need for urinary reconstruction, the bladder will likely not be able to hold as much urine and more frequent urination may result.
• Radical cystectomy – removal of the bladder, which usually is performed for more advanced bladder cancer. Lymph nodes near the bladder in the pelvis also are removed. The prostate is removed in men, while in women, the uterus, cervix, part of the vagina, ovaries and fallopian tubes are removed. Depending on your cancer and age, a reproductive organ-sparing approach may be possible. Reconstructive surgery is then needed to restore urinary function.
• Completely robotic cystectomy and urinary reconstruction – both bladder removal and urinary reconstruction are performed completely robotically — resulting in faster recovery and shorter hospital stays.

Urinary Reconstruction after Bladder Cancer Surgery

When bladder cancer surgery requires removing some or all of the bladder, one of the following bladder reconstruction procedures is used to restore urinary function:

• Ileal neobladder – part of the ileum (small intestine) is used to make a new bladder, allowing for more normal urination.
• Ileal conduit – a piece of small intestine is used to create a so-called pipe connecting the ureters to the surface of the skin. Urine drains into a urostomy bag outside the body.
• Continent reservoir – small and large intestines are used to create an internal pouch connected to the navel. A catheter is used to drain the pouch every few hours.

At Houston Methodist, our experts perform both the cystectomy and urinary reconstruction completely robotically as often as possible — resulting in faster recovery and shorter hospital stays.

Immunotherapy for Bladder Cancer

Immunotherapy is used to treat some bladder cancers. The goal of this type of therapy is to stimulate the immune system to better recognize and fight the cancer.

The types of immunotherapy used to treat bladder cancer include:

• Intravesicle Bacillus Calmette-Guerin (BCG) to activate immune cells in the bladder
• PD-1 and PD-L1 inhibitors that block checkpoint proteins on immune cells
• Monoclonal antibodies designed to target a specific protein on bladder cancer cells

Chemotherapy for Bladder Cancer

Chemotherapy is the use of drugs to kill cancer cells. For bladder cancer, chemotherapy can be given systemically or deposited directly into the bladder itself.

Chemotherapy for bladder cancer may be recommended in combination with other bladder cancer treatments, such as radiation therapy, as well as before bladder cancer surgery to help ensure the tumor is completely removed, or after bladder cancer surgery to destroy any remaining cancer cells.

Radiation Therapy for Bladder Cancer

Radiation therapy uses a beam of high-energy X-rays or other particles to destroy cancer cells in a targeted area.

During bladder cancer treatment, radiation therapy can be used as:

• Part of early-stage bladder cancer treatment after TURBT
• The primary mode of treatment for those with early-stage bladder cancers who cannot undergo surgery or chemotherapy
• A way to try to avoid surgical removal of the bladder
• Part of a palliative care treatment plan aimed at reducing the symptoms of advanced bladder cancer