Organ-Sparing Bladder Surgery Lets Cancer Patient Enjoy Life

Edith Washington spent 24 years taking care of others as a home health aide, so the 44-year-old mother and grandmother has always been vigilant about her own health. When she was diagnosed with bladder cancer and was told she needed surgery, Edith was worried and concerned about how her life would be impacted. But thanks to her attentive care team at University Hospitals and an innovative bladder reconstruction surgery, Edith is back to living life on her own terms just months after her diagnosis.

The Diagnosis

Edith first noticed blood in her urine last July. With a history of urinary tract infections (UTIs) dating back to childhood, she didn’t want to take any chances, so she took action right away. Working with University Hospitals urogynecologist Sangeeta Mahajan, MD, Edith was put on antibiotics, but they didn’t help. At this point, they decided to take a look at her bladder again through a cystoscopy procedure. When the results suggested some abnormalities, Edith was referred to UH urologic oncologist Adam Calaway, MD.

“Dr. Calaway was very vigilant and very fast acting,” says Edith. “I learned it was cancer on Oct. 31 and by December I was having the surgery.”

Choosing the Right Surgery

Edith’s cancer required the surgical removal of the bladder. The standard protocol for female patients has been to remove a large portion of the female reproductive system along with the bladder – including the uterus, cervix, fallopian tubes, ovaries and the anterior wall of the vagina.

But this protocol may not always be the right option, especially in otherwise young and healthy patients such as Edith. It can impact the patient physiologically – with the loss of the ovaries and hormone function – and can lead to sexual dysfunction through the loss of vaginal length and lubrication.

Dr. Calaway was able to perform an organ and vaginal sparing bladder removal, allowing Edith to maintain her ovaries and vaginal length. Her bladder was rebuilt using the neobladder procedure, a type of urinary diversion rarely performed in females. It was the first female neobladder procedure performed at University Hospitals in many years.

With neobladder, a new bladder is created from a portion of the patient’s intestines. It allows patients to urinate voluntarily and maintain control of urination.

Edith explained why she felt the neobladder procedure was the best fit for her, in terms of her age and lifestyle: “It was the more invasive surgery, but it was the surgery that would get me back to being myself.”

Recovering from Surgery

The surgery went well, though there were a few complications involving infection of the drainage tubes after surgery. But after the infection was treated and the tubes removed, Edith recovered quickly.

“It came out better than expected,” says Edith. “Before the surgery, I went into panic mode thinking about how life will change. But once it’s all over, it’s much better than you could have imagined.”

Edith says she’s feeling wonderful after her surgery. She has great bladder control, and never experienced any urinary incontinence. She goes to the bathroom like normal, and just uses a catheter twice a day to ensure the bladder is fully emptied. She says the biggest change was retraining herself to recognize the sensation of a full bladder, which feels different with her reconstructed bladder.

Edith is happy to report that she was able to have sex successfully after surgery and hasn’t experience any sexual dysfunction. She’s also pleased with the size and placement of the surgical scar, which she says is barely noticeable.

All of the things I was worried about, I turned out to be worrying for nothing,” she says.

Enjoying Life, Cancer-Free

On January 31, 2023, Edith was declared cancer-free. Other than the surgery, she did not require any further cancer treatment. She will continue to have follow-up scans every six months for the next few years in order to make sure the cancer doesn’t return. But otherwise, she’s feeling good and back to normal. Since the surgery, she’s returned to work as an independently contracted medical courier and enjoys spending time with her four adult children and seven grandchildren.

Edith says she would definitely recommend the neobladder procedure to younger patients who want to maintain a normal sex life. While she wishes there was a different cure for bladder cancer, this is the best option out there.

She is also grateful to her care team at UH and how they cared for her while she was being treated.

“Everybody was really cooperative, understanding and patient,” she says. “They were always right on top of things and professional. They never let me feel alone.”