Shah’s Gastro, Cancer & Robotic Surgery Centre
Tapping Book on WhatsApp will likely open the WhatsApp app on your phone.
Last updated: 02-Nov-2026
Assessment, surgery and follow-up for bladder cancer · Gota OPD, Gota, Ahmedabad · Apollo Hospital, Bhat, Gandhinagar
IN SHORT
Blood in the urine, even once, needs a look inside the bladder. It is bladder cancer until a test says it is not.
The first operation, done through the urine passage, is also the test that stages the tumour. It must reach the muscle layer to be useful.
A tumour on the surface is sorted into four risk groups. The group decides the drops, the follow-up and whether the bladder should come out.
A tumour in the muscle is planned at a tumour board before any date is fixed. Medicine often comes first.
Dr Swati Shah
MS, DrNB (Surgical Oncology)
Bladder Cancer Surgeon
Apollo Hospital, Bhat, Gandhinagar · Gota OPD, Gota, Ahmedabad · 18 years of experience
★★★★★ 4.99 from 84 Google reviews (Gota clinic) · 5.0 from 37 (Apollo, Bhat)
Who writes this page. Dr Swati Shah holds MS, DrNB (Surgical Oncology). She studied medicine and trained in general surgery at Maulana Azad Medical College, Delhi. She trained in surgical oncology at Rajiv Gandhi Cancer Institute and Research Centre, Delhi. She has 18 years of experience in cancer surgery, and has worked on the robotic console since 2013. Consultation, assessment, surgery and follow-up run as one pathway.
Every person with a bladder tumour in the muscle is discussed at a tumour board before treatment starts. The board has a cancer surgeon, a medical oncologist, a radiation oncologist, a radiologist and a pathologist. The order of treatment is settled there. It is not one surgeon’s call.
This page is about how the decisions are made. The operation to remove the bladder, and the choice between a new bladder and a bag, are set out on cystectomy with neobladder or ileal conduit.
Red urine without pain is the usual first sign. One episode that clears up still needs a full check.
Most people find the cancer because of blood in the urine. It may come once and stop. Many are told it is an infection, take a course of tablets, and see it settle. The cancer is still there. It returns months later, often deeper.
Some people have no blood at all. They have a burning or an urgent need to pass urine that does not respond to tablets. This is how a flat, aggressive type called carcinoma in situ can show itself.
The first visit answers three questions. Is there a tumour, what does it look like, and are the kidneys and ureters clear.
A thin telescope is passed into the bladder in the clinic. It shows how many tumours there are, how big, and where. It also shows whether a tumour is a frond-like growth or a flat velvety patch. The flat patch matters, because it can be carcinoma in situ.
| At the first visit | Why it is done then |
|---|---|
| Telescope look into the bladder, with the findings drawn and written down. | It records number, size and site, and shows any flat patch. |
| A CT scan with contrast that also images the kidneys and ureters, ideally before the operation. | The upper urine tubes can carry the same cancer. Swelling after an operation makes the bladder wall hard to read. |
| Urine test for cancer cells. | It picks up high-grade disease well. A clear result never rules out a slow-growing tumour. |
| Blood tests including kidney function. | Kidney function decides whether the strongest chemotherapy drug can be used. |
| A chest scan when the tumour may be in the muscle. | It looks for spread before a big operation is planned. |
| Smoking, diabetes, weight, nutrition and heart health. | These decide how much surgery the body can take. |
The tumour is shaved out through the urine passage. The piece of bladder muscle under it must be in the specimen, or the stage is a guess.
This operation is called a transurethral resection, or TURBT. No cut is made on the belly. The surgeon removes the visible tumour in layers and sends the base separately, with a piece of the muscle layer, so that the pathologist can say how deep the cancer has gone.
Once the report is back, a surface tumour is placed in one of four groups. This is the single most useful step in planning.
| Group | What it looks like | What is usually advised |
|---|---|---|
| Low risk. | One small, slow-growing tumour, first time, no flat patch. | The single wash after the operation and then watching with the telescope. No further drops. |
| Intermediate risk. | Several or returning slow-growing tumours, or larger ones, not in the high or very high group. | A course of chemotherapy drops or a year of BCG, with regular telescope checks. |
| High risk. | A tumour into the layer below the lining, a fast-growing type, or a flat patch of carcinoma in situ. | BCG for up to three years. A cystectomy is discussed in some. |
| Very high risk. | High-grade growth into the lining layer together with a flat patch, many or returning tumours of that type, spread into the prostate passage, tumour in small vessels, or an unusual cell type. | Removal of the bladder is raised first. BCG is used if the person declines or is not fit. |
BCG is a weakened germ placed in the bladder to wake up the immune system against the tumour. It is given weekly after the wound has healed.
It starts a few weeks after the resection, never over a raw bed. A first course runs for six weeks. Further doses at set months follow for those at higher risk. For intermediate risk a year is the plan, and for high and very high risk up to three years.
A tumour in the muscle is treated as a major cancer. The plan is made at the tumour board before any date for surgery.
A scan can understate how far a tumour has gone. A fair share of tumours that look muscle-deep on imaging prove to be deeper once the bladder is removed. So the scan stage is not counselled as if it were the final truth.
Removing the bladder, with the lymph glands around it, is the standard for a tumour in the muscle. Keeping the bladder is real, and suits only a few.
In a cystectomy the bladder and the lymph glands of the pelvis are removed. In a man the prostate goes with it, and in a woman nearby organs may sometimes be spared, which changes sexual function. This is discussed before surgery. The operation can be done by robot-assisted keyhole surgery or open surgery. The cancer operation is the same. The route is chosen for your body and your scans, and not by habit.
| Choice | Who it suits | What to know |
|---|---|---|
| Cystectomy with a bag (ileal conduit). | Most people, especially older, frail, or with weak kidneys. | A permanent stoma and appliances for life. Simplest operation, fewest later operations. Monthly appliance cost is real, and is discussed before you choose. |
| Cystectomy with a new bladder (neobladder). | Younger, fit, with good kidneys and willing to learn to empty it. | No bag. Leakage at night is common, and some people need to use a catheter to empty it, sometimes for life. |
| Keeping the bladder (resection plus radiation with chemotherapy). | A single small tumour that was fully removed, no flat patch, no swelling of the kidney. | Not the easy option. It needs lifelong telescope checks, and the bladder is removed later in some, through tissue already treated with radiation. |
Risks are named here in words. Your own figures are given in person before consent, for your disease and your fitness.
| What | What it means |
|---|---|
| After cystectomy the way urine leaves the body changes for life. Certain. | Either a stoma with a bag, or a new bladder built from bowel that is emptied in a different way. |
| Sexual function changes after cystectomy. Certain to some degree. | This is discussed openly with you and your partner before surgery, including what can be spared. |
| Bleeding or a clot after the first resection. | Passed with fluid washing, and sometimes a return to the operating room. |
| A hole in the bladder wall during the resection. | Usually managed with a catheter. Rarely it needs a repair through the belly. |
| Leak from the bowel join, or a blocked ureter, after cystectomy. | Watched for closely. Some need a drain, a tube or a second operation. |
| Risk to life. | Real in a major operation, and higher with weak kidneys, poor nutrition or a low immune state. Your own figure is given in person. |
Bladder cancer comes back often. Regular checks with the telescope are a part of treatment and not an extra.
| Who | What is done |
|---|---|
| Low risk. | Telescope check at three months and again at a year, then yearly for several years if clear. |
| Intermediate risk. | Telescope and urine test every three to six months at first, then spaced out. The upper tubes are imaged from time to time. |
| High and very high risk. | Telescope and urine test every three months for the first two years, then every six months. Upper tubes are imaged yearly. |
| After cystectomy. | Review with scans of the chest, belly and pelvis at regular intervals in the first years, then yearly. Kidney function, vitamin B12 and the stoma or new bladder are checked. |
| At home. | Stop smoking. It cuts the chance of return. Report blood in the urine on the same day, not after a week. |
The reviews below are Google reviews of this surgeon from families treated for bladder cancer. No two people have the same disease or the same plan.
★★★★★
“We came from Jodhpur for my wife bladder cancer treatment under Dr. Swati Shah. We are grateful for her guidance, support, and professional approach throughout the treatment journey. She explained everything clearly and made us feel comfortable and confident. We truly appreciate her care and dedication. Thank you, Dr. Swati Shah, for your support and treatment.”
— mahendra Joshi, Google review
★★★★★
“We are very thankful to Dr. Swati Shah for her excellent treatment and care for urinary bladder cancer. She explained the condition and treatment options clearly and made us feel confident throughout the treatment journey. Her expertise, dedication, and compassionate approach are truly appreciated. We are very happy with the care and support received. Highly recommended for anyone looking for an experienced cancer surgeon.”
— A K, Google review
★★★★★
“We came from Surendranagar for my father's urinary bladder cancer treatment. Dr. Swati Shah performed robotic surgery to remove the bladder and created a new urinary bag . The surgery went smoothly — there has been no leakage issue, and urine control is also well maintained. We are very satisfied with the care and outcome. Highly recommend Dr. Swati Shah for uro-oncology and robotic surgery.”
— Rana Digvijaysinh, Google review
These are shown exactly as Google holds them. They describe one family’s experience, and no two people have the same disease or plan.
The cost depends on which treatment is done, the route, and the length of stay. A written estimate is given before admission.
Apollo Hospital, Bhat, Gandhinagar works with the major insurers and with cashless cover, and its office handles the pre-authorisation. For a cystectomy, bag appliances after discharge are a monthly cost that families often forget, so we raise it at the first visit. Please bring every scan, the cystoscopy note, the biopsy report, the slides if you hold them, your medicine list and your insurance card.
Yes. Blood in the urine that clears on its own is still bladder cancer until a telescope test and a scan say otherwise. Treating it as an infection and waiting is the commonest way a tumour is caught late.
The first report either had no muscle in it, or the tumour was high-grade or had grown below the lining. In those cases the first operation may have missed the true depth, and a repeat check changes the plan.
It sorts a surface tumour into low, intermediate, high or very high risk. The group decides whether you need drops, for how long, how often the bladder is checked and whether removal of the bladder is raised.
No. A low-risk tumour needs only the single wash after the operation. Intermediate risk may be given chemotherapy drops, especially while BCG is in short supply. BCG is kept first for the high and very high groups.
Not for most surface tumours. It is advised for tumours in the muscle, for the very high risk group, and when BCG has failed. Keeping the bladder is possible in a few, and needs the radiation team to agree at the start.
For a tumour in the muscle, usually yes, if kidney function and general health allow. The course is given first because it improves the outcome, and surgery follows within a few weeks of its end.
No. Robot-assisted keyhole surgery and open surgery are both done, and the cancer operation is the same. The route is chosen for your body, your scans and safety.
Passing clots, or being unable to pass urine. Fever with shivering after BCG or any operation. A swollen, painful leg. Fever or a leaking wound after cystectomy. Do not wait for the next visit.
Shah’s Gastro, Cancer & Robotic Surgery Centre
Dr Swati Shah — MS, DrNB (Surgical Oncology) · Bladder Cancer Surgeon
Consultation: Gota OPD, Gota, Ahmedabad. Surgery: Apollo Hospital, Bhat, Gandhinagar.
Gota OPD — Gota, Ahmedabad, Gujarat. Directions
Apollo Hospital, Bhat, Gandhinagar — Apollo Hospital International Limited, Plot No. 1 A, GIDC Bhat Industrial Estate, Bhat, Gandhinagar, Gujarat 382428. Directions
Call: +91-63590-11009 · WhatsApp: +91-63590-11009
People travel to Ahmedabad for this surgery from across Gujarat, southern Rajasthan and western Madhya Pradesh.
Told you have a tumour in the bladder? Send the cystoscopy note, the scan and any biopsy report ahead. The consultation then starts with them already read. The plan is made after examination, and at the tumour board. Call +91-63590-11009 · Bring the reports to the visit
Tapping Book on WhatsApp will likely open the WhatsApp app on your phone.
Swasth Parivar: every week, practical advice on recovery, diet and warning signs. No advertising. Stop any time.
Your number is used for these updates and for the clinic to reach you. It is never sold or passed on. To stop, reply STOP on WhatsApp.
