A cystectomy is a surgery to remove all or part of the bladder:
Reasons for a cystectomy include:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
Previous surgery in the abdomen or pelvis, or radiation 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.
General anesthesia is given before surgery. You will be asleep.
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.
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About 3–6 hours
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.
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
You may have to restrict some of your activities while you recover. This may take 4-6 weeks. Home care may include:
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:
If you think you have an emergency, call for medical help right away.
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.
Last reviewed May 2014 by Michael Woods, MDLast Updated: 5/29/2014