TOTAL CYSTECTOMY AND URETERAL TRANSPLANTATIONS IN MALIGNANT CONDITIONS OF THE BLADDER

Abstract

The surgeon who is in constant contact with cases of bladder neoplasm is singularly struck by the paradox of curability of this disease. Whereas simple fulguration or irradiation provides absolute cure in many malignant conditions of varying size and location, one frequently sees one's best directed efforts go for naught in situations which at their onset seem the most hopeful. The Cancer Registry¹is providing valuable data regarding progress in dealing with this problem, but a scrutiny of the reports offers a shocking reminder that in too vast a proportion of cases the generally accepted criteria of treatment are inadequate. Compared to other visceral neoplasms, bladder carcinomas do not tend to become metastatic at an early date and should perhaps therefore be more often cured than is obviously the case. One might reasonably raise the question as to whether early radical surgery in the form of cystectomy might not