Kukreja is the director of urologic oncology at the CU Cancer Center and UCHealth University of Colorado Hospital.

Dr. Janet Kukreja

For patients undergoing a radical cystectomy, staying active before and after surgery is key, Dr. Janet Kukreja explained.

Staying Active is Vital After Undergoing Bladder Cancer Surgery 

For patients with bladder cancer undergoing radical cystectomy (the surgical removal of the bladder), remaining active is crucial, 

“I generally recommend that patients recover from surgery at home, but staying active, and the best way to get ready for surgery is also the same, staying active,” said Kukreja. “So, I often have patients, even well into their 80s, doing long walks multiple times a day, making sure they're eating high protein [diets] and stuff like that so their body can recover [from surgery].”

Kukreja is the director of urologic oncology at the CU Cancer Center and UCHealth University of Colorado Hospital. She sat down with CURE for an interview about the patient experience of radical cystectomy.

What should patients expect during and after Bbadder removal surgery?

From a patient's perspective, getting ready for the surgery, having the surgery, and then recovering from the surgery are the main parts. I generally recommend that patients recover from surgery at home but stay active, which is also the best way to get ready for surgery. I often have patients, even well into their 80s, do long walks multiple times a day and make sure they're eating high-protein diets and things like that so their bodies can recover.

I generally like to perform bladder removal surgery with laparoscopic robot assistance. This means we make small incisions in the abdominal wall, put ports through them, and then insert the instruments through the ports and dock the robot. This allows me to get deep into the pelvis and see everything. When you do the surgeries open, it's very hard to get both hands into the pelvis and perform very fine surgery, at least for me. So, we remove the bladder, and often we remove lymph nodes with it as well to make sure that the cancer hasn't spread. Then we create some sort of 

, [which is] some way to reroute the urine to leave the body.

Transcript has been edited for clarity and conciseness.

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Dr. Janet Kukreja explains one urinary diversion option available to patients undergoing bladder removal.

What is a Neobladder? What Patients with Bladder Cancer Need to Know

For patients with bladder cancer undergoing radical cystectomy, or the surgical removal of the bladder, one possible option is to then receive a neobladder. Under this procedure, a new bladder is created from a section of the small intestine.

“I generally like to do [bladder removal surgeries as] laparoscopic robot assisted,” said Dr. Janet Kukreja in an interview with CURE. “So what that means is we make little incisions in the abdominal wall, and we put ports through them, and then we put the instruments through the ports and dock the robot to those. But, what it allows me to do is it allows me to get really deep into the pelvis and be able to see everything. When you do the surgeries open, it's very hard to get both hands in the pelvis, and do a very fine surgery, at least for me anyway. So we do the bladder removal, often we remove lymph nodes with it as well to make sure that the cancer hasn't spread to the lymph nodes. And then we make some sort of urinary diversion, some way to reroute the urine to leave the body.”

Among Kukreja’s patients is Deion Sanders, the football star and coach at the University of Colorado. Sanders, 57, made news this month when he announced that had received a diagnosis of bladder cancer, but his care team considered him cured after the surgical removal of his bladder.

Sanders, Kukreja explained, then received a neobladder. Speaking with CURE, she detailed what a neobladder is and how it functions for patients.

What we do is we use small intestine, and we form it into a ball, and then we hook it to the urethra, and inside we sew it to the urethra, and then we hook the kidneys up as well on the inside, so that the urine drains down into it and it becomes a new reservoir. It's different than native bladders. It doesn't have a muscle on it. So, your native bladder has a muscle that does this. Neobladders don't have a muscle, but they serve as a very low-pressure reservoir which is good for your kidneys to drain into. And so people empty it by pushing their abdominal muscles down, as if they're really constipated or have to think of it as a balloon in the pelvis that they have to deflate with their abdominal muscles, and to push the urine out they do that.

Transcript has been edited for clarity and conciseness

Dr. Janet Kukreja

Staying Active is Vital After Undergoing Bladder Cancer Surgery

What is a Neobladder? What Patients with Bladder Cancer Need to Know

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