Bladder Removal Surgery - Risk to Colon +

I just had a second opinion for my bladder cancer at KU Med Center. The doctor threw a bunch of data at me as far as complications go. I do not remember the exact number for colon damage, but I remember it was very low. I want to say it was 1%.

Yes, that's correct. Dad is still trying to decide between a radiation approach and the radical cystectomy. He is leaning toward surgery, but very scared by potential of waking up with a colostomy bag in addition to the urostomy. We have been told that the risk is there, but not very large, but don't really know what that means - 1/50, 1/50, 1/5? And we don't know how much the risk of this specific complication goes up with a patient that has been through brachytherapy. For the surgical option, we are working with Dr. Castle at the Mayo Clinic in Phoenix, who seems to be a leader in his field.

Thanks,

Ray

Thanks very much Amanda. I should have been more clear - my father's surgery would entail removal of bladder, prostate, and some lymph nodes. From what I understand, because the prostate sits right next to the colon, there is a remote risk of colon damage during the operation, which could lead to a colostomy on top of the bladder removal. Making matters worse, my father had brachytherapy for prostate cancer many years ago, which was very successful. However, the radiated seeds embedded in the prostate can thin the wall between the prostate and the colon over time, increasing the risk of colon damage during the operation. This is my dad's worst nightmare, so we are trying to get a handle on the increased risk. We've spoken to two surgeons on the topic, but both were vague in their responses. Perhaps we need to be more assertive!

Thanks again,

Ray

I dont know if this helps as it sounds like your operation is different to my husband's. He had his bladder, prostate and lymph nodes removed and has an indiana pouch.

As part of this they use a part of the colon for the pouch and the small intestine ileum to provide the valve needed to stop leakage (all very clever), and more small intestine for the tube to the stoma.

Are you referring to the prostate medication damaging the colon, or the operation itself? I can't see how a bladder removal would 'damage' the colon unless you were having part of it removed as my husband did.

He hasn't had any problems with his colon (yet), and it's now 6 months since his surgery. They had to wait until his stomach/colon gurgled until he could have anything (even ice chips) by mouth. This ensured that the colon was all fully back and functional before they tried to get it to do anything again. Seemed to work well.

I'd ask the surgeon/oncologist. They're far more likely to have read up on the data, and should be able to tell you any risks involved.

Amanda

I did a search to see if this topic was covered but didn't see anything - apologies if I missed something.

Has anyone seen data on the risk of colon damage as part of bladder removal surgery, and how existing brachytherapy prostate treatment (radioactive seed implants) increases this risk? We've asked around a bit but nobody has been able to tell us anything remotely concrete. Thanks.