The bladder is the reservoir in which urine from the kidneys is stored before being released during urination.

DISEASE

An abnormality in your bladder has been detected or is suspected by radiological, biological or endoscopic examinations.

Only the microscopic examination of the removed tissue will make the exact diagnosis allowing us to offer you the treatment and follow-up adapted to your situation.
The absence of precise diagnosis and treatment exposes you to the risk of allowing a dangerous lesion to develop, possibly cancerous or likely to become so.

ARE THERE OTHER OPTIONS?

There is no other way than the intervention proposed to you to allow the removal or removal of the bladder anomaly that you present.

PRINCIPLE OF INTERVENTION

The procedure offered to you is intended to remove or take a sample of your bladder lesion and have it analyzed under a microscope.
to wash the bladder and prevent urine from turning red. It is also important to urinate regularly and avoid holding it in for too long. You are also advised to avoid significant effort and movement in the first week following the procedure.

The prescriptions given to you include the daily injection of an anticoagulant. Maintaining anticoagulant treatment is necessary after your hospitalization to prevent the risk of phlebitis. It may be advisable to wear compression stockings for at least 10 days after your procedure.

A letter has been sent to your attending physician to keep him informed of your state of health.
The duration of convalescence and the date of return to work or normal physical activity depend on your physical condition. You will discuss with your urologist the date of resuming your activities and the follow-up after the operation.

A post-operative consultation is scheduled with your urologist to inform you of the results of the microscopic examination of the surgical specimens and the continuation of your care.

RISKS AND COMPLICATIONS

In the majority of cases, the intervention offered to you takes place without complications. However, any surgical procedure carries a certain number of risks and complications described below:

Some complications are linked to your general condition and the anesthesia; they will be explained to you during the pre-operative consultation with the anesthetist or surgeon and are possible in any surgical procedure.

Complications directly related to the procedure are rare, but possible. They can be classified into complications:

• Usual
• When the bladder catheter is in place, painful bladder contractions may occur, these are sometimes associated with urine leaking along the catheter.
• You may feel a moderate burning sensation or have bleeding when urinating for 24 to 48 hours.
• If these disorders persist, you must contact your doctor or urologist.

• Occasional
• Persistent urinary bleeding justifying prolonged wearing of the catheter.
• Infection of the urogenital system requiring appropriate antibiotic treatment, more rarely severe infection with the passage of germs into the blood which may require intensive care.
• Obstruction of the probe requiring unblocking maneuvers and/or its replacement.
• Bleeding from the urethra called urethrorrhagia, which can be associated with difficulty passing urine due to clots.

• Rare
• Urinary bleeding during or after the operation which may require a transfusion and/or further surgery.
• Wound of the bladder or an organ of the abdomen during the procedure most often requiring prolonged wearing of the probe and exceptionally immediate surgical repair.
• Inability to resume urination after removal of the probe.
• The product used to wash the bladder during the procedure may cause ionic disorders in the blood and lead to visual disturbances, nausea, discomfort, and exceptionally coma.
• Injury to the urethra, immediate or remote.
• Ureter injury requiring additional treatment.
• Cardiovascular or anesthesia-related problems requiring treatment in an intensive care unit. The most common causes are pulmonary infections, pulmonary embolisms, strokes, phlebitis, myocardial infarction, the most severe forms of which can lead to death.
• Certain events should require you to be consulted without delay: fever above 38°5, malaise, calf pain, difficulty breathing, difficulty urinating, appearance of blood in the urine, abdominal pain, vomiting, blockage of urine with the impression of poor emptying of the bladder.

PRECAUTIONS ON LEAVING THE CARE STRUCTURE

Prevention of phlebitis and pulmonary embolism

Bed rest and lack of movement of the lower limbs promote venous stasis. Pain in one leg, a feeling of heaviness or a reduction in tossing of the calf should suggest phlebitis. It is therefore necessary to consult a doctor urgently.
In order to avoid the occurrence of phlebitis, it is advisable to follow the recommendations given to you: regular and frequent contractions calves, foot movements, leg elevation and following your doctor’s prescription, wearing compression stockings.

In the event of chest pain, side stitches, irritating cough or shortness of breath, it is necessary to consult urgently because these signs may indicate a pulmonary embolism. Then immediately contact your doctor or the nearest emergency service by calling the Center.

SIGNS THAT MAY OCCUR AND WHAT TO DO

Hematuria (blood in the urine)

The aftermath of your procedure is most often marked by the presence of blood in the urine. You are therefore asked to drink very regularly and abundantly to dilute the blood and thus prevent the formation of clots. These may be responsible for the persistence of bleeding or, if they are present in abundance, may be responsible for blocking the emptying of your bladder.

The observation of pink urine is usual and should not worry you.
Hematuria can also occur one to three weeks after the procedure. This corresponds to the recurrence of bleeding at the bottom of the scar area (bed sore fall). You must then drink again abundantly and regularly; the persistence of abundant blood (very red urine) and clots in your urine, despite drinking copiously, should lead you to consult your urologist. It may then be necessary to put a catheter in your bladder, and very rarely to operate to stop the bleeding.

Urethrorrhagia

It corresponds to the emission of blood through the urethra. It occurs rarely, is generally scanty and resolves spontaneously.

Burns when urinating

Mild pain may occur when urinating. Its accentuation or persistence, or the appearance of cloudy urine may correspond to a urinary infection, which justifies carrying out a bacteriological examination of the urine (ECBU).

This ECBU can show leukocyturia (presence of very numerous leukocytes) and hematuria (red blood cells in the urine). These two anomalies are usual and indicate ongoing healing.

In the absence of abundant germs, it is not a urinary infection: no antibiotics are then necessary.

Abdominal pain or nausea and vomiting

These symptoms may reflect the passage of urine into the abdominal cavity through communication with the bladder at the resection area. These symptoms should cause you to consult an absolute emergency. A bladder catheter should be placed without delay.

Difficulty urinating

force of the jet may seem weak for the first few days. A worsening of these difficulties in urinating (abdominal thrust, dribbling urination, etc.) may raise fears of urinary blockage (retention) and warrant medical advice. It is then necessary to quickly contact your urologist or consult urgently:

• if the difficulties in emptying the bladder increase to the point of fear of no longer being able to urinate
• if you have a complete blockage, i.e. urine retention.

Fever

Any unexplained fever may be related to a urinary tract infection. It requires that you consult your doctor or urologist who will prescribe a urine test to look for bacteria.

Lower back pain

Exceptionally, you may have lower back pain related to an obstruction of the ureter canal where it enters the bladder. These pains may correspond to gravity or intense pain in a lumbar fossa. The occurrence of these symptoms should lead you to consult your urologist; the intensity of the pain and the presence of fever will guide the urgency of the consultation.