Once a patient has blood in their urine (haematuria) it is recommended they first have a bladder TCC (transitional cell carcinoma) ruled out. The patient will be sent for urine cytology tests through a pathologist and possibly a CT scan. The most definitive way to rule out bladder cancer is through a cystoscopy and biopsy. Dr Al-Sameraaii offers the cystoscopy/biopsy both in theatre and in office.
Once the biopsy confirms cancer of the bladder you will have a consultation with Dr Al-Sameraaii about your options.
Symptoms of bladder cancer can include:
Haematuria - blood in the urine
Urinary frequency – frequent need to pass urine
Pain and burning during urination
Locations: Calvary Bruce Private Hospital, Canberra Private Hospital, Calvary John James Hospital
In theatre under general anaesthetic, Dr Al-Sameraaii will insert a resectoscope (similar to cystoscope) through the urethra and up into the bladder. Once the tumour is visualised, Dr Al-Sameraaii will resect it using a small wire loop and Bugbee monopolar diathermy will be applied. The resected tissue will be sent to a pathologist for confirmation of disease.
The procedure can take between 15-30 minutes and the patient can go home the same day.
The patient will be followed up with a bladder inspection every six to nine months to confirm no recurrence of the bladder cancer or urothelial cancer.
Locations: Calvary Bruce Private Hospital, Calvary John James Hospital
A radical cystectomy and lymph node dissection are for more advanced cancer of the bladder.
Once under general anaesthesia, Dr Al-Sameraaii will remove the bladder along with nearby lymph nodes. It is possible he may need to remove parts of nearby organs for males such as the urethra, prostate and seminal vesicles or for females the urethra, uterus, ovaries and possibly part of the vagina.
Dr Al-Sameraaii will then create a stoma through the abdominal wall using a piece of the small intestine to create a tube that attaches to the ureters and connects the kidneys to the opening of the abdominal wall (Ileal conduit).
This can be a lengthy procedure possibly taking multiple hours and the patient can expect a medium length hospital stay.