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My operation in France: bladder polyp removal

The inside story of readers who have had operations in France – and how they found the health service, by Gillian Harvey

Former cake decorator Anne Pollard, 71, retired to Charente-Maritime in 2008 with husband Paul, but he died that same year. Anne was in good health, until she experienced unexplained bleeding in 2015.

Initial symptoms

I experienced intermittent bleeding from my urethra, and went to my GP. He suggested I went to see a gynaecologist, but I was not convinced, as I was certain the bleeding was coming from my bladder.

When I did see the gynaecologist he told me that although I had a few fibroids, they were not large enough to cause bleeding.

My GP sent me for an ultrasound where a large polyp was discovered in my bladder. Although my GP wanted to refer me to the gynaecologist again, I convinced him to also make an appointment with a urologist at the hospital in Saintes.

The urologist finally confirmed that, as I had suspected, the bleeding was coming from the polyp, and I was booked in to have the polyp removed.

The operation

I arrived at the hospital the night before the operation, and was taken to the surgical wing the next morning.

The operation was performed under epidural and took just over an hour. I was back in my room by the afternoon and discharged two days later.

Unfortunately, polyps have continued to return to my bladder and I have now had the procedure a further six times over the last three years.

The doctor believes much of the problem is caused by the fact I used to smoke, although I gave up five years ago.

Apparently chemicals can be absorbed into the blood and filtered by the kidney before entering the bladder in urine.

Now, if I need to have a polyp removed, I arrive in the morning rather than the night before. For my last operation in June 2018, I arrived at 7.00, was in theatre by 9.00 and back in my room by 14.00 the same day.

For all but the latest operation (in which the surgeon wanted to check my kidney) I have had an epidural, and have been able to watch the procedure on a screen to see exactly what they were doing.

I have also attended the hospital several times to have an ‘instillation’ into my bladder with the aim of ridding my body of the harmful bacteria.

A catheter is inserted into the bladder and a solution is inserted. I then have to hold the solution in my bladder for as long as possible – ideally two hours.

Usually I am allowed to go home, but for the latest instillation I had to remain in hospital for the day while they monitored my urine output, as the chemicals they had used were stronger.

Aftercare

As I am on blood-thinning medication, which I have to stop taking a week before each operation, I am visited by a nurse after discharge who gives me an injection of an anti-coagulant.

This tends to cause a lot of bruising!

A month after each procedure, I have a follow-up appointment with my urologist, who performs an endoscopy where a camera is inserted into the bladder to check the healing and whether there are any new polyps forming.

If there are, I am then booked in so that they can deal with them as quickly as they can. I am positive that the latest instillation has been successful.

I certainly feel fitter and healthier than I have for the past three years.

Throughout, the care has been marvellous. I cannot fault the French healthcare system and particularly the hospital at Saintes and the doctors who have cared for me there.

In fact, I recently described Dr Yassine, my urologist, as “my favourite man!”

This caused the nurses to giggle, but it’s absolutely true – he’s the only man I’ve seen regularly for the past three years.

 

FACTS ON BLADDER POLYPS by Dr Christian Castagnola – vice president Association Française d’Urologie (AFU) 
www.urologie-sante.fr

What causes bladder polyps?

In France, 12,000 people a year develop bladder tumours or polyps, most commonly in over-60s men. The main cause is smoking or exposure to toxic matter such as grade tar or solvents.

How do surgeons remove polyps?

The operation is done under local or general anaesthetic. An antibiotic may be given with a urine test for infection.

Using an endoscope via the urethra, removal is done under video control. The whole bladder is checked. The ‘resector’ removes the lesion and coagulates vessels likely to bleed.

How long does it usually take?

The duration depends on the number of polyps and their size, but usually between 30 minutes and an hour.

How long are patients in hospital?

This varies, decided by your surgeon and depending on the surgery, general health and the type and severity of lesion. It is normally one to three days.

What is the normal prognosis?

Prognosis depends on whether the polyp invaded the bladder wall muscle and the level of cellular aggression.

Survival rate for tumours that did not invade the muscle is 80-90% at five years, with a 50% risk of recurrence of the polyp and 15% risk of progression (invading the muscle). Patients must have regular cystoscopy monitoring.

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