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12 July 2026Medical History
Patient Profile
- Age: 79 years
- Gender: Male
Diagnosis
- Diagnosed with bladder cancer based on a biopsy performed at another medical centre.
Clinical Findings
- Bilateral nephrostomy catheters were in place to provide urinary drainage from both kidneys and prevent kidney failure.
- A large bladder diverticulum was identified on the left side of the bladder.
- Preoperative imaging demonstrated that the diverticulum was completely occupied by the tumour.
Surgical Plan
The primary objectives of the procedure were:
- To perform endoscopic removal of the bladder tumour.
- To replace the external nephrostomy drainage with internal ureteral stents.
- To improve the patient’s quality of life by eliminating the need for external drainage catheters.
Surgical Procedure
During the operation:
- The distal portion of the left ureter was found to be obstructed by the tumour.
- The obstructed area was carefully opened.
- Methylene blue was administered through the nephrostomy catheter to identify the urinary tract.
- The diverticulum was entered, and tumour tissue was removed.
- A ureteral stent was inserted through the region where the ureter was believed to enter the diverticulum.
- A ureteral stent was also successfully placed on the right side.
- Fluoroscopic imaging was used intraoperatively to confirm correct stent placement.
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Postoperative Findings
- Bilateral ureteral stents were successfully placed.
- The external nephrostomy catheters were planned for removal.
- A large bladder tumour was removed during the procedure.
- The tumour tissue was considered to have been completely resected.
Postoperative Plan
- Removal of the nephrostomy catheters was planned for the following day.
- The patient was expected to be discharged if the postoperative course remained uneventful.
