(Radical Bladder Removal, Partial Bladder Removal)
DefinitionA 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 ProcedureReasons for a cystectomy include:
- Cancer of the bladder
- Problems with nerve-muscle control of the bladder
- Bladder damage from radiation or chemotherapy
- Bladder damage or bleeding from other conditions, treatments, or injuries
Possible ComplicationsProblems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Loss of sexual function
- Fluid build-up in the abdominal cavity
- Damage to other organs
- Blockage of urine flow from the ureters to the bladder
- Nutrition problems, depending on the bowel segments used to create a way for urine to drain
- Blood clots
- Reaction to anesthesia
- Urinary incontinence
What to Expect
Prior to ProcedureYou 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.
AnesthesiaGeneral anesthesia is given before surgery. You will be asleep.
Description of ProcedureAn 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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How Long Will It Take?About 3–6 hours
How Much Will It Hurt?Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Average Hospital StayThe 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.
Post-procedure CareAt the Hospital
- A stay in the intensive care unit may be needed.
- Be encouraged to walk with assistance soon after surgery
- During 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.
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
- Caring for your surgical wound
- Exercises to strengthen your pelvic floor
- Physical therapy or rehabilitation
Call Your DoctorIt 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 chills
- Redness, swelling, increasing pain, heavy bleeding, or discharge from the incision and/or stoma site
- Persistent nausea and/or vomiting
- Pain that you cannot control with the medications you were given
- Inability to urinate or difficulty urinating, extreme cloudiness or pus in the urine, a bad odor to the urine
National Kidney and Urologic Diseases Information Clearinghouse
Urology Care Foundation
Canadian Urological Association
Public Health Agency of Canada
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.
- Reviewer: Michael Woods, MD
- Review Date: 05/2014
- Update Date: 05/29/2014