Cystectomy

(Radical Bladder Removal, Partial Bladder Removal)

Pronounced: sis-TEK-toh-mee

Definition

A cystectomy is surgery to remove all or part of the bladder. There are two types:

  • Partial: removes part of the bladder
  • Radical: removes all of the bladder, nearby lymph nodes, and part of the tube that carries urine out of the bladder

Reasons for Procedure    TOP

You may need this to treat:

  • Severe interstitial cystitis
  • Problems with nerve-muscle control of the bladder
  • Bladder problems or bleeding from things like radiation, chemotherapy, or injuries

Possible Complications    TOP

Problems may happen. Your doctor will review some problems, such as:

  • Infection
  • Bleeding
  • Loss of sexual function
  • Fluid build-up in the belly
  • Harm to other organs
  • Blockage of urine flow
  • Blood clots
  • Problems with anesthesia
  • Loss of urine control

Before your procedure, talk to your doctor about ways to manage things that may raise your risk of problems, such as:

Your risk of problems is higher if you have had surgery in the belly or pelvis or have had radiation therapy.

What to Expect    TOP

Prior to Procedure

You may need to take antibiotics to block infection. You may also need to take laxatives to empty your bowels.

The night before, you may be told not to eat and to only drink clear liquids. Your doctor may not want you to eat or drink after midnight or on the morning of the surgery. Make sure you know what to do.

Talk to your doctor about your medicines. You may be asked to stop taking some up to one week before surgery.

Anesthesia

General anesthesia is given before surgery. You will be asleep.

Description of Procedure    TOP

A cut will be made in the abdomen. It will let the doctor view the bladder. In a radical cystectomy, all blood vessels to the bladder will be cut. The bladder will be removed. The doctor may also remove nearby lymph nodes, part of the tube that carries urine from the bladder, and any nearby organs. In men, these organs are the prostate and glands that help make semen. . In women, they are the uterus, ovaries, and, vagina.

The doctor will also need to make a new way for urine to leave the body. A new bladder may be built. This can be done using pieces of intestine. Or, an external bag may be attached to the belly (urostomy).

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 cuts and a camera.

Kidneys, Ureters, and Bladder

The Urinary System
Copyright © Nucleus Medical Media, Inc.

How Long Will It Take?    TOP

About three to six hours

How Much Will It Hurt?    TOP

Anesthesia will prevent pain during surgery. Pain after can be managed with medicines.

Average Hospital Stay    TOP

The usual length of stay is 5 to 12 days. The length of time you stay will depend on your health and the reason for surgery. Your doctor may also choose to keep you longer if you have problems.

Post-procedure Care    TOP

At the Hospital

  • You may need to stay in the intensive care unit.
  • You will walk with help soon after surgery.
  • During surgery, the doctor placed a tube from the nose to the stomach. It will stay there for several days. Because you can’t eat with the tube in place, you will get IV fluids.
  • If the doctor attached a urine bag, you will be taught how to get rid of urine.

During your stay, staff will take steps to lower your chance of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your cutsx covered

There are also steps you can take to lower your chance of infection, such as:

  • Washing your hands often and reminding staff to do the same
  • Reminding staff to wear gloves or masks
  • Not allowing others to touch your cuts

At Home

You may have to limit some of your activities while you get better. This may take 4 to 6 weeks. Home care may mean:

  • Exercises to help your pelvic floor get stronger
  • Physical therapy or rehabilitation

Follow your doctor’s instructions.

Call Your Doctor    TOP

Alert your doctor to any problems right away. Call your doctor if you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, more pain, heavy bleeding, or leaking from the cut or stoma site
  • Nausea and vomiting
  • Pain that you can't control with the medicines you were given
  • Problems urinating, cloudiness or pus in the urine, a bad odor to the urine

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov
Urology Care Foundation
http://www.urologyhealth.org

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org
Public Health Agency of Canada
http://www.phac-aspc.gc.ca

References:

Treating bladder cancer. Bladder Cancer Advocacy Network website. Available at: https://www.bcan.org/treatments/. Accessed July 30, 2018.
Aboumarzouk OM, Drewa T, Olejniczak P, Chlosta PL. 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. 2012;38(3):330-340.
Liss MA, Kader AK. Robotic-assisted laparoscopic radical cystectomy: history, techniques and outcomes. World J Urol. 2013;31(3):489-497.
Last reviewed June 2018 by EBSCO Medical Review Board Kathleen A. Barry, MD
Last Updated: 7/30/2018

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