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Cystectomy
all information

Cystectomy

Pronounced: sis-TEK-toh-mee

En Español (Spanish Version)

Definition

A cystectomy is a surgery in which all or part of the bladder is removed.

Parts of the Body Involved

Bladder

Reasons for Procedure

Reasons for a cystectomy include:

Risk Factors for Complications During the Procedure

Complications such as bleeding or damage to the bowel or rectum can occur. Previous surgery in the abdomen or pelvis, or radiation to the area can increase your risk.

What to Expect

Prior to Procedure

Doctors recommend you quit smoking before surgery. You may also be required to take antibiotics and laxatives to clean the bowels.

The night before, you may be asked not to eat anything and only drink clear liquids. After midnight and on the morning of the procedure, do not eat or drink anything. This includes avoiding clear liquids, coffee, tea, or water.

Anesthesia

General anesthesia is given before surgery. You will be completely asleep and will not feel pain during the procedure.

Description of the Procedure

An incision is made in the abdomen to expose the bladder. All blood vessels to the bladder are cut. The bladder is removed. Other tissues and organs may also need to be removed with the bladder.

Kidneys, Ureters, and Bladder

The Urinary System

© 2008 Nucleus Medical Art, Inc.

The surgeon will also 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.

After Procedure

A stay in the intensive care unit for 2-3 days may be required. When you awake from surgery, you may have a tube running from the nose into the stomach. Strenuous activity should be avoided for 4-6 weeks.

If a urine bag was attached during the surgery, you will need to learn how to dispose of urine.

How Long Will It Take?

The process takes between 1-5 hours. The length will depend on the reason and the type of surgery

Will It Hurt?

Recovery following cystectomy is usually painful.

Possible Complications

Reaction to the general anesthesia is possible. Other possible complications from the surgery include:

  • Infection in the body or at the incision site may occur.
  • Bleeding may occur.
  • Loss of sexual function may occur.
  • If cancer was the reason for the surgery, additional treatment may be necessary.
  • Leaking fluid may pool in the abdominal cavity.
  • The rectum may be injured and require surgery.
  • The intestines could leak or narrow, requiring surgery.
  • Blockages could prevent urine flow.
  • Metabolic and nutritional complications may arise depending on the bowel segments used to create a urinary diversion.
  • Clots in lower extremities.

Average Hospital Stay

You may need to stay in the hospital for 2-12 days. The specific length will depend on your condition and the reason for surgery.

Postoperative Care

Intravenous fluids are given for several days following surgery. A tube will be placed from the nose to the stomach for several days.

Once released from the hospital, strenuous activity should be avoided for 4-6 weeks. Patients should also avoid heavy lifting, straining, and sexual activity for a period of time. Driving, showering, and climbing stairs is usually allowed.

Outcome

Prognosis varies based on the reason for the surgery but it is usually good. If cancer was the cause, the risk exists for the cancer returning.

Call Your Doctor If Any of the Following Occurs

Call your doctor immediately if you:

  • Have difficulty urinating or cannot urinate
  • Are nauseous or vomiting
  • Have a fever

RESOURCES:

American Foundation for Urologic Disease
http://www.afud.org

American Urological Association
http://www.auafoundation.org

CANADIAN RESOURCES:

Canadian Health Network
http://www.canadian-health-network.ca

Canadian Urological Association
http://www.cua.org/

References:

Bladder cancer. AP John Institute for Cancer Research website. Available at: http://www.apjohncancerinstitute.org/cancer/bladder.htm . Accessed February 25, 2007.

Medical tests and procedures: radical cystectomy. Franciscan Medical Group website. Available at
https://www.fhshealth.org/medSurg_proced/cystectomy.asp. Accessed February 25, 2007.

Wash PC, Vaughan ED, Wein AJ, Kavoussi LR, Novick A, Partin AW. Campbell’s Urology. 8th ed. Saunders; 2002.



Last reviewed March 2008 by Miguel Antelo, 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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