A cystectomy is a surgery to remove all or part of the bladder: A radical cystectomy removes all of the bladder, nearby lymph nodes, part of the urethra, and nearby organs that may contain cancer cells.A partial cystectomy removes part of the bladder.
Reasons for a cystectomy include: Cancer of the bladderProblems with nerve-muscle control of the bladder
Bladder damage from
chemotherapyBladder damage or bleeding from other conditions, treatments, or injuries
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: InfectionBleedingLoss of sexual functionFluid build-up in the abdominal cavityDamage to other organsBlockage of urine flow from the ureters to the bladderNutrition problems, depending on the bowel segments used to create a way for urine to drainBlood clotsReaction to anesthesiaUrinary incontinence
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as: SmokingDrinking
Chronic diseases, such as
Previous surgery in the abdomen or pelvis, or
to the area increases your risk of complications.
You may need to take antibiotics to prevent infection and laxatives to clean out your bowels.
The night before, you may be asked not to eat anything and to only drink clear liquids. Do not eat or drink anything after midnight or on the morning of the procedure. This includes avoiding clear liquids, coffee, tea, and water.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
An incision will be made in the abdomen to expose the bladder. In a radical cystectomy, all blood vessels to the bladder will be cut. The bladder will then be removed along with nearby lymph nodes, part of the urethra, and nearby organs that may contain cancer cells. In men, the prostate and glands that help produce semen will also be removed. In women, the uterus, ovaries, and, sometimes, part of the vagina will be removed.
The doctor will also need to create a new way for urine to be passed out of the body. A new bladder may be built using pieces of intestine or an external bag may be attached to the abdomen.
In a partial cystectomy, only part of the bladder will be removed.
Either procedure can be done by laparoscopic or robotic-assisted laparoscopic techniques using a number of smaller incisions and a camera.
Kidneys, Ureters, and Bladder
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Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is 5-12 days. The specific length of time will depend on your condition and the reason for surgery. Your doctor may also choose to keep you longer if complications occur.
A stay in the intensive care unit may be needed.Be encouraged to walk with assistance soon after surgeryDuring surgery, a tube will be placed from the nose to the stomach. It will stay there for several days. Because you cannot eat with the tube in place, you will receive IV fluids.If a urine bag was attached during the surgery, you will be taught how to dispose of urine.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as: Washing your hands often and reminding your healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incision
You may have to restrict some of your activities while you recover. This may take 4-6 weeks. Home care may include: Caring for your surgical woundExercises to strengthen your pelvic floorPhysical therapy or rehabilitation
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor: Signs of infection, including fever and chillsRedness, swelling, increasing pain, heavy bleeding, or discharge from the incision and/or stoma sitePersistent nausea and/or vomitingPain that you cannot control with the medications you were givenInability to urinate or difficulty urinating, extreme cloudiness or pus in the urine, a bad odor to the urine
If you think you have an emergency, call for medical help right away.
Aboumarzouk OM, Drewa T, et al. Laparoscopic radical cystectomy: A 5-year review of a single institute's operative data and complications and a systematic review of the literature.
Int Braz J Urol. 201238(3):330-340.
Bladder cancer facts. AP John Institute for Cancer Research website. Available at:
http://www.apjohncancerinstitute.org/cancer/bladder.htm. Accessed May 29, 2014.
Cystectomy information binder. Johns Hopkins Medicine website. Available at:
http://urology.jhu.edu/bladder/Cystectomy.pdf. Accessed May 29, 2014.
Liss MA, Kader AK.
Robotic-assisted laparoscopic radical cystectomy: history, techniques and outcomes.
World J Urol. 2013;31(3):489-497.
Maffezzini M, Campodonico F, et al. Current perioperative management of radical cystectomy with intestinal urinary reconstruction for muscle-invasive bladder cancer and reduction of the incidence of postoperative ileus.
Surg Oncol. 2008;17(1):41-48.
Last reviewed May 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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