SEOUL, KOREA - EWHA Womans University Mokdong Hospital(EUMC)’s artificial urinary bladder surgery (in which a part of the patient’s small intestines is made into a reservoir (or neobladder) finds favor with bladder cancer patients since there is no need for them to wear external urinary pouches that cystectomies always accompany. This year, the EUMC (www.eumc.ac.kr/mokdong) came out on top in the number ofartificial urinary bladder surgeries in the nation.
The EUMC logged 21 artificial urinary bladder surgeries in 2011, 33 in 2012 and 40 in 2013. From January to October of this year, it performed 51 artificial urinary bladder surgeries, emerging as the No.1 hospital in urinary reconstruction and diversion in the nation.
Given the fact that even large hospitals perform, on average, 40-50 operations urinary bladder surgeries a year, the EUMC’s 51 urinary bladder surgeries during the 10-month period shows that it is undeniably the leader in urinary reconstruction and diversion.
The EUMC’s artificial urinary bladder surgery is a highly technical surgical procedure that makes urine to exit the body in a urinary diversion: a part of the small intestine is surgically converted into a neobladder and connected to the ureter. It is much more sophisticated than creating Indiana pouch reservoirs, but is definitely more beneficial to patients.
Urologist Lee Dong-hyeon at the EUMC not only dramatically halved the duration of artificial urinary bladder surgery (which used to last over 8 hours) but also made it transfusion-free. Thus, elderly patients (over 70) and patients with chronic illnesses, such as diabetes and hypertension, can undergo his artificial urinary bladder surgery.
Furthermore, a reservoir or pouch is made out of a portion of the small intestine to ensure that the patient normally urinates. On top of that, urologist Lee uses nerve-preserving surgical techniques which allow patients to lead a healthy sex life even after the surgery. Satisfied patients spread positive word of mouth; bladder cancer patients flock to the EUMC to consult with urologist Lee Dong-hyeon.
Urologist Lee attributes the development of such innovative surgical techniques to the synergies gained from the combination of the EUMC medical staff’s endeavors for better, differentiated medical services and hospital-wide all-out support.
“As life expectancy is getting longer and longer, more elderly patients opt for artificial urinary bladder surgery. I believe that the number of patients favoring artificial urinary bladder surgery will continue to rise because it makes a huge difference in their lives after surgery,” said Urologist Lee.
* Bladder cancer and artificial urinary bladder surgery
Bladder cancer is one of the most common cancers found in the urinary system. It is divided largely into three stages: Stage 1. The cancer cells are confined to the inside layer of the lining of the bladder (urothelium). Stage 2. The cancer has grown through the muscle of the bladder and into the fat layer surrounding it. Stage 3. The bladder cancer spreads to other parts of the body. Stage 1 simply entails surgical removal of the tumor through a cystoscope. Stage 3 probably necessitates systemic (whole body) chemotherapy.
Cystectomy is carried out when the cancer has grown through the muscle of the bladder and into the fat layer surrounding it (since it may have spread to the prostate, lymph glands or seminal vesicles). The patient has to wear an external urine pouch that is applied to the abdomen to drain urine from the ureter into the pouch. Here, a 20 cm abdominal incision is made in the intestine.
Such a surgical method is the safest and easy-to perform option, but the patient has to carry a urine pouch attached to this abdomen all the time. And the pouch sometimes leak out to the skin, thus the patient constantly has to check whether the pouch is completely filled.
However, as urologist Lee’s artificial urinary bladder surgery featuring an intestine-turned neobladder guarantees pouch-free normal urination, more patients opts for it. After surgery, patients can even go on a hike without an aesthetically displeasing urine pouch on the abdomen. Therefore, his patients have been highly satisfied with the results of urologist Lee’s surgery.
by leejaeson (jaesonlee@koreaittimes.com)
