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The preliminary assessment of this condition is to stage the spread of the disease.
An initial assessment of the depth of spread of the tumor into the depth of the bladder wall is made by a procedure called Trans Urethral Bladder Tumor Resection . This is a biopsy and serves as an important guide for the type and staging of the disease. Additional a CT scan of the abdomen is usually done.
If the disease has remained in the superficial layers only , it s a Non Muscle Invasive Bladder Cancer(NMIBC). This needs only instillation of drugs in the bladder periodically ( Intravesical Instillation ) and bladder surveillance with periodic cystoscopy of the bladder.
If the disease had invaded in the depth of the bladder muscle , then it is a Muscle Invasive Bladder Tumor. This disease has the potential to spread rapidly in the body. It hence needs removal of the bladder and Chemotherapy . Sometimes Radiaiton is also added.
The operation of bladder removal is Radical Cystectomy. In most cases the urinary passage can be reconstructed using the intestine to fashion a new bladder ( Neo Bladder). On other occasions, a small length of intestine is connected to the ureters to drain the urine externally ( Ileal Conduit)