Mr. Kapil, a 52-year-old gentleman from Munger, Bihar was referred to us with history of passing blood with urine. In his family his mother had also undergone treatment for lung cancer. He was not a smoker or tobacco user.

On evaluation he was found to have a tumor in his urinary bladder which was confined to the bladder. He received some treatment at his native place without any relief.

Cystoscopy and Biopsy revealed that it is a muscle invasive transitional cell carcinoma (Kind of Bladder Cancer). For this kind of cases bladder needs to be removed which is called Radical Cystectomy but, in this kind of cases, bladder can be preserved by removing just the affected portion of bladder while preserving the remaining normal portion of Bladder (Partial Cystectomy). After discussion and counseling, Mr. Kapil agreed to the plan and we did Partial Cystectomy. We also removed adjacent pelvic lymph nodes. After the surgery he was back to his normal life within few days. He has now a normally functioning bladder and free from cancer.

Usually, a muscle invasive localized urinary bladder cancer requires surgery in which we remove the whole urinary bladder and either we make an artificial bladder using patient's own intestine or we make an opening in abdominal wall called stoma through which urine comes out and get collected in a bag which remains attached with patient's abdomen.

So, patient with urinary bladder cancer usually land up either with stoma or with an internal neobladder.

The internal neobladder made from patient's own bowel loop does not have the normal urinary sensation when it is filled with urine as we normal people feel when we have urge to pass urine and patient has to learn some maneuver to pass urine at regular intervals. Despite that the removal of whole bladder and creating a new bladder inside body is a much-complicated surgery requiring 6-8 hours’ time.

The stoma has its own stoma related complications. The stoma bag needs to be changed at regular intervals. Many times, the patient is not comfortable with stoma which remains there for whole life and there is a continuous uneasiness due to altered body image due to presence of stoma.

In this patient we could avoid both the need of stoma as well as neobladder and we could preserve his urinary bladder. His surgery was less time consuming and less complicated than those required for removing whole bladder and creating a stoma or a neobladder.

Message from this story for all is

• Urinary bladder can be preserved if the tumor is suitable located and is localized to the bladder.
• Early diagnosis and treatment are must for better outcome.
• Do not ignore even a single drop of blood in urine, get investigated as early as possible