Learn about Ayu Health Hospital’s successful case of Radical Cystectomy With Right Cutaneous Ureterostomy.
Radical Cystectomy With Right Cutaneous Ureterostomy
Kantha Devi, a woman in her late 50’s from Himachal Pradesh’s Mandi district, was suffering from severe stomach aches and had blood in her urine. She was being treated in a local clinic for a while, but when the pain became unbearable and the medications weren’t helping, her brother, Niresh Kumar, decided to hunt for better hospitals in Chandigarh.
He started his search for reliable hospitals online to treat his sister because he didn’t know where else to seek. That’s when he discovered Ayu Health Hospitals.
He travelled to Chandigarh, where he was assisted by Anurag, the patient care coordinator at Ayu Health Hospitals. After explaining the situation to the patient care coordinator, he was introduced to Dr. Gaurav Sharma, consultant Urologist and Andrologist.
Dr. Gaurav decided to run diagnostics to better understand the reason for Kantha Devi’s symptoms.
What Dr. Gaurav Sharma uncovered
“Kantha Devi came to us with a complaint of hematuria (blood in the urine), but the tests revealed something far more serious.”
Following CT scans and ultrasounds, it was discovered that she had urinary bladder cancer. A biopsy taken through the urinary tract revealed that she had high-grade cancer which was muscle invasive. Her creatinine levels were also over 4.0 mg/dL.
Creatinine: A waste product produced by the body’s muscles as a result of natural wear and tear. The amount of creatinine in your blood or urine can help your doctor figure out how well your kidneys are operating. Age, race, gender, and physical size all influence blood creatinine levels.
The typical creatinine level in women and adolescents aged 16 and up is 0.6–1.1 mg/dL.
People with one working kidney have a normal creatinine level of around 1.8 or 1.9 mg/dL.
But if there is severe kidney damage the levels range anywhere between 2.0 – 5.0 mg/dL.
But that wasn’t it. Her kidneys were also severely damaged. Her left kidney was rendered completely non-functional because of a stone that formed years ago and was left untreated. The right kidney was hardly functioning because the cancer had progressed to the urine pipe, obstructing it and creating considerable swelling.
Her cancer stage ( TNM staging) was t3bn3m0. Meaning, the cancer had penetrated the bladder tissue, the vagina, and the surrounding lymph nodes. However, no distant metastasis was discovered.
Distant Metastasis: Refers to cancer that has spread from the original (primary) tumor to distant organs or distant lymph nodes. Also called distant cancer.
How it was treated
Usually, chemotherapy is employed to lower the stage of cancer, but since Kantha Devi’s kidneys were already pretty damaged, she could not be a candidate for chemotherapy.
Radical Cystectomy was then used as a course of treatment. It’s a rare procedure where the patient’s bladder is completely removed. The uterus, ovaries, and a portion of the vagina are also removed during a Radical Cystectomy.
Since the bladder, the organ that retains urine was removed, a new method of storing urine and releasing it was required. Hence, a procedure called Cutaneous Ureterostomy was performed. The ureter for Kantha Devi’s functional kidney (right) was brought to the surface of the abdomen by creating an opening. This way, the urine is collected in a bag through the abdominal opening.
Two months later
When Kantha Devi was admitted to Ayu Health Hospital, she was very sick. She needed dialysis, blood transfusion and went into recurrent sepsis.
But now, with a creatinine level of 3, she’s happy and healthy. She is able to eat well and has gained a healthy weight.
“I would like to thank Ayu Health Hospital and Dr. Gaurav for giving my sister a new life”
- Niresh Kumar
Ayu Health Hospital’s Urology department is staffed with the best specialists who are trained in treating different kinds of cancer, be it urinary, bladder, kidneys or prostate.
Cancer treatment can be both exhausting and frightening. Our specialists at Ayu Health Hospitals strive to maintain two-way communication and share all options with you and your family to help you and your family make better decisions.
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About the Author
Dr. Udaybhaskar M
Dr. Uday Bhaskar is a renowned urologist currently practicing at Ayu Health Hospital, Bangalore.
He is proficient in Endourology, RIRS, (open and laparoscopy), andrology (penile lengthening & penile prosthesis for erectile problems), and other urological procedures. Over the course of his career, he has performed many laser TURPs for prostate enlargement. He also has vast experience in treating renal stones and performing PNCLs.