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Invasive Bladder Cancer Requires Radical Treatments, says Urologist Paul Perito MD

Paul Perito MD

Paul Perito MD

A radical cystectomy can remove most cancer cells but it is not without major risks, according to Paul Perito MD.

According to Paul Perito MD, a radical cystectomy is an operation used to remove the bladder, as well as any surrounding organs that are affected by carcinogenic cells. Paul Perito MD, a Coral Gables, Florida-based urology specialist, explains that the procedure has been around since the 1800s but it was not until the mid-20th century that the basic principles of surgery were described in medical texts. According to Paul Perito MD, the procedure was updated in 1987 to accommodate a nerve sparing dissection that would preserve sexual function. Paul Perito MD notes that the average hospital stay for radical cystectomy is around seven days. Although this is considered a major surgery, advancements in medicine have lowered the instance of intensive care post-operatively.

According to Paul Perito MD, bladder cancer is either a non-muscular or muscularly invasive disease. Transitional cell carcinoma (TCC) is the most prevalent form of bladder cancer. Instances of TCC rose rapidly from the mid-1980s to the mid-1990s and in 2008 an estimated 14,000 people died of the condition, reports Paul Perito MD. Bladder cancer is more common in men than women, and the diagnosis rate is higher among Caucasians than African Americans.

There are specific environmental risk factors generally associated with bladder cancer, notes urologist Paul Perito MD. Smoking and exposure to certain paints, dyes, and solvents, as well as prior radiation therapy are all common in patients presenting with TCC or other less common forms of bladder cancer. Since TCC can progress at varying speeds, early detection is imperative to control the spread of carcinoma beyond the lining of the bladder, says Paul Perito MD. Low fluid intake, treatment with certain drugs such as Cytoxan and Neosar (drugs used during chemotherapy), and long-term catheter placement are also considered agents that may increase the incidence of bladder cancer, reports Paul Perito MD.

According to the urologist and surgeon, a radical cystectomy may be performed through a small dissection in the lower abdomen. It is often available as a laparoscopic procedure, adds urologist Paul Perito MD. Once the bladder and surrounding infected tissue have been removed, a surgeon may utilize a portion of the small intestine to create an ileal conduit which will then be mapped though a urostomy into sterile bag to be emptied as needed, reports Paul Perito MD. If the urethra remains intact, a neo-bladder may be created which will allow an urination process similar to the pre-operative condition.

Recovery after a cystectomy may take 6 to 8 weeks for completion, reports Paul Perito MD. Men with bladder cancer may also have to undergo a radical prostatectomy if the cells spread to the prostate. Urine leakage, infection, bowel obstruction, injury to the rectum, as well as infertility are all common complications of a radical cystectomy procedure.

This is not a comprehensive guide to bladder cancer or radical cystectomy, cautions Paul Perito MD. More information can be obtained by an open conversation with your urologist or by scheduling an appointment at Perito Urology by calling 305-444-2920 or on the web at www.peritourology.com

Paul Perito MD is a Coral Gables, Florida-based urologist whose practice, Perito Urology, specializes in men’s health issues. Most notably, Dr. Perito has developed and actualized a minimally invasive penile implant procedure that is safe, efficacious, and proven to diminish the risk of infection to the patient. He is the Chairman of the Urology Department at Coral Gables Hospital as well as an active member of the American Urological Society. Paul Perito MD has traveled abroad extensively to promote his minimally invasive penile implant technique. He is a 1988 graduate of the University Of Maryland Medical School and also holds a BA in chemistry from Emory University.

The information contained in this article is provided by Paul Perito MD for educational purposes only. It is not intended to treat or diagnose any condition.


  1. Hi Paul Perito MD, I appreciate your efforts on discussing this and sharing this information with us. Looking forward to learning some more regarding this topic from you, Paul Perito MD.

    • @Zanjo – Thanks for leaving a comment “Invasive Bladder Cancer Requires Radical Treatments, says Urologist Paul Perito MD” – Paul Perito MD

  2. Treatment for localized stage TCC is a surgical resection of the tumor, but recurrence is common, correct? Why is it more men than women that have bladder cancer Paul Perito MD? It seems that if women get UTI’s more than men, then it would be the other way around, Paul Perito MD.

    • @Gilbert – Men are often urged to be on the lookout for prostate cancer or testicular cancer. Thanks Gilbert for the feedback. “Invasive Bladder Cancer Requires Radical Treatments, says Urologist Paul Perito MD” – Paul Perito MD

  3. If you have a simple cystectomy or radical cystectomy, Paul Perito MD, is it advisable to create a new way for the urine to exit your body? I am just curious what you think about this. Thanks for responding and for sharing this information.

    • @Richard – Yes, an ileal conduit uses a piece of your small intestine to make a tube. Your ureters are the two tubes that normally carry urine from the kidneys to the bladder. “Invasive Bladder Cancer Requires Radical Treatments, says Urologist Paul Perito MD” Thank you so much for leaving a comment. – Paul Perito MD

  4. Is there a way to prevent bladder cancer, Paul Perito MD? There are a lot of questions that I have regarding this and would love to have more information if you could share it. Thanks!

    • @Kennedy – There is a lot of way to prevent that kind of disease like not to smoke too much expose to chemical like paints, textiles and printing materials. “Invasive Bladder Cancer Requires Radical Treatments, says Urologist Paul Perito MD” Thanks! – Paul Perito MD

  5. Hello, Paul Perito MD how will know the symptoms of bladder cancer? I am looking forward to reading your response as well as gleaning more knowledge from you soon, Paul Perito MD.

    • @Mikey – Symptoms can also be similar too much less serious conditions, so it is important to see your doctor if you experience them. “Invasive Bladder Cancer Requires Radical Treatments, says Urologist Paul Perito MD” Thanks! – Paul Perito MD

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