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Department of Urology SLK Kliniken Heilbronn - Disorders of the urinary bladder

Diagnosis and treatment in bladder incident and urinary bladder cancer

In Germany every year there are 13,000 men and 5,000 women develop bladder cancer approximately. The risk increases from the 40th year of life.

We are specialised in endoscopic diagnosic modalities. In addition to ultrasound and intravenous pyelography, we offer fluorescence diagnostics for bladder cancer (early diagnosis), ureterocystoscopy (TUR-B) and contrast diagnostic (AUG) The Urology Heilbronn treated benign diseases of urinary bladder like e.g. the bladder incident and we are specializing in the treatment of malignant bladder tumors.

Bladder prolapse (cystocele)

The bladder prolapse is based on a weakening of retaining structures, cause an excessive decrease of the vagina and uterus. The descent of the anterior vaginal wall is connected with the lower base of the bladder, named cystocele. These disease blisters a feeling like a pressure pain or drop feeling, lower back ache and a frequent urge to urinate, leading to repeated urinary tract infections.

Almost every woman is affected by this disease increasingly at higher age. The causes are in a hereditary disposition, connective tissue and muscle weakness of the supporting pelvic floor structures or complicated births and overweight.

A congenital connective tissue will be encouraged the development of the pelvic floors decrease by excessive physical exercise like lifting and carrying heavy loads.

Pelvic floor gymnastics assists proactively and in the case of common severity. If the symptoms persist and are accompanied by urinary incontinence, surgery is inevitable to reconstruction and stabilization.

Superficial bladder

Most often, the growth of bladder cancer is limited to the inner lining of the bladder and infects the mucous membrane. Although these tumors are under control by endoscopic techniques, but some patients get new tumors again.

Ureterocystoscopy is an approved method to diagnose and treat superficial urinary bladder cancer in an early stage based on the principle of TUR-B combined with postoperative instillation chemo- or immunotherapy (BCG, Mitomycine C).

At the Department of Urology SLK Kliniken Heilbronn the treatment of superficial tumors at an early stage focuses on the transurethral Elektroresektion (TUR-B) which can be combined with photodynamic diagnosis (PDD). The results are excellent in conjunction with the local administration of growth-inhibiting substances such as chemotherapy drugs.

Invasive urinary bladder cancer

The therapy requires integrated surgical methods of bladder cancer.

Invasive bladder cancer grows massively in the tissue and muscles or superficial stretch off in several places in the bladder, infection of the lymph nodes. Only a removal of the bladder (radical cystectomy) and possibly compromised lymph nodes can offer a lifesaving treatment in this case. Experience our medical teams in urology Heilbronn allows a laparoscopic surgery again.

The treatment of bladder cancer depends on how deep the tumor invades into the bladder wall.

Tumors that infiltrate the bladder require more radical surgery where part or mostly all of the bladder is removed and the urine is diverted. In some cases, we create a substitute bladder (called 'neobladder') from a segment of intestinal tissue, depends upon patient preference, age of patient, renal function, and the site of the disease. Recently, this operation can be performed also by laparoscopy.

A combination of radiation and chemotherapy can also be used to treat invasive disease. Despite the alternative continent methods, ileal conduit ensures a good quality life preserving renal function.

Polychemotherapy is the standard treatment in the case of progessive cancer applied as inpatient or outpatient (i.e. M-VEC; Cisplatinum-Gemcitabine).

The treatment concept of the Department of Urology SLK Kliniken Heilbronn includes operational and reconstructive opportunities:
- Photodynamic-diagnostic of superficial bladder cancer and transurethral resection (TUR)
- Laparoscopic and open surgical Cystectomy
- DaVinci ® assisted radical Cystectomy
- Urinary diversion
- Neobladder
- Ileal conduit
- Systemic and intravesical chemotherapy