Overview Of Cystectomy

Cystectomy (sis-TEK-tuh-me) is a surgery to remove the urinary bladder.

In men, removing the entire bladder (radical cystectomy) typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy also involves removal of the uterus, ovaries and part of the vagina.

After having your bladder removed, your surgeon also needs to create a urinary diversion — a new way to store urine and have it leave your body. There are multiple ways that urine can be stored and eliminated after bladder removal. Your doctor can help you decide which method is best for you.

Often, cystectomy is performed to treat invasive or recurrent noninvasive bladder cancer. Cystectomy may also be performed to treat other pelvic tumors — such as advanced colon, prostate or endometrial cancer — and some noncancerous (benign) conditions — such as interstitial cystitis or congenital abnormalities.

Why it’s done

Your doctor may recommend cystectomy to treat:

  • Cancer that begins in the bladder or that begins nearby and grows to involve the bladder
  • Birth defects that affect the urinary system
  • Neurological or inflammatory disorders that affect the urinary system

What type of cystectomy and reconstruction you have depends on several factors, such as the reason for your surgery, your overall health and your preferences. Discuss your options with a surgeon to determine which procedures are right for you.

Risks

Cystectomy is a complex surgery, involving the manipulation of many internal organs in your abdomen. Because of this, cystectomy carries with it certain risks, including:

  • Bleeding
  • Blood clots
  • Heart attack
  • Infection
  • Pneumonia
  • Rarely, death can happen after surgery

Since cystectomy is a surgery not just to remove the bladder but also to create a urinary diversion, the surgery includes additional risks, such as:

  • Dehydration
  • Electrolyte abnormalities
  • Urinary tract infection
  • A blockage that keeps food or liquid from passing through your intestines (bowel obstruction)
  • A blockage in one of the tubes that carries urine from the kidneys (ureter blockage)

Some complications may be life-threatening. You may need to go back to the operating room for surgery to fix the complication, or you may need to be readmitted to the hospital. Ask your surgeon what additional risks there may be for your particular surgery.

How you prepare

Before cystectomy, talk with your doctor about the medicines you take and your use of caffeine, alcohol or other drugs. You may need to make changes to your medications or avoid certain substances to help with healing and recovery after surgery.

If you smoke, the best thing you can do for your health is to quit before surgery. Not only is smoking a risk factor for developing bladder cancer, smoking also increases the risk of developing problems after surgery.

When you schedule your surgery, you’ll receive specific instructions on how to prepare for the procedure. If you have questions about the instructions, follow up with your surgeon or other member of your health care team.

What you can expect

During cystectomy, your surgeon removes the bladder and part of the urethra, along with nearby lymph nodes. In men, removing the entire bladder (radical cystectomy) typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy also involves removal of the uterus, ovaries and part of the vagina. Your surgeon also creates a new route for urine to leave your body.

Your surgeon may recommend one of these approaches for your surgery:

  • Open surgery. This approach requires a single incision on your abdomen to access the pelvis and bladder.
  • Minimally invasive surgery. Your surgeon makes several small incisions on your abdomen where special surgical tools are inserted to access the abdominal cavity.
  • Robotic surgery. During this type of minimally invasive surgery, your surgeon sits at a console and remotely operates the surgical tools.
What you can expect

During cystectomy, your surgeon removes the bladder and part of the urethra, along with nearby lymph nodes. In men, removing the entire bladder (radical cystectomy) typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy also involves removal of the uterus, ovaries and part of the vagina. Your surgeon also creates a new route for urine to leave your body.

Your surgeon may recommend one of these approaches for your surgery:

  • Open surgery. This approach requires a single incision on your abdomen to access the pelvis and bladder.
  • Minimally invasive surgery. Your surgeon makes several small incisions on your abdomen where special surgical tools are inserted to access the abdominal cavity.
  • Robotic surgery. During this type of minimally invasive surgery, your surgeon sits at a console and remotely operates the surgical tools.