(Radical Bladder Removal, Partial Bladder Removal)
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
This surgery may be done to treat:
- Bladder cancer
- Problems with nerve-muscle control of the bladder
- Bladder problems or bleeding from things like radiation, chemotherapy, or injuries
- Severe interstitial cystitis (rare)
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Blood clots
- Loss of sexual function
- Fluid build-up in the belly
- Harm to other organs
- Blockage of urine flow
- Loss of urine control
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
The doctor will give general anesthesia. You will be asleep.
Description of Procedure
There are two different methods:
An incision will be made in the belly. In a partial cystectomy, only part of the bladder will be removed. 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 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). The incision will be closed with stitches. A bandage will be placed over the area.
Small incisions will be made in the belly. A scope with a small camera on the end will be passed through one of the incisions. The camera will display the area on a video screen. Robotic arms holding tools may be inserted through the holes. In a partial cystectomy, only part of the bladder will be removed. 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 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). The incisions will be closed with stitches. A bandage will be placed over the incisions.
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How Long Will It Take?
About three to six hours
Will It Hurt?
Pain and swelling are common in the first 1 to 2 weeks. Medicine and home care can help.
Average Hospital Stay
The usual length of stay is 5 to 12 days. If you have any problems, you may need to stay longer.
At the Hospital
Right after the procedure, the staff may:
- Give you pain medicine
- Ask you to get up and walk to improve bowel function and blood flow
- Teach you how to drain urine if a urostomy was done
During your stay, staff will take steps to lower your chance of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to lower your chance of infection, such as:
- Washing your hands often and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not allowing others to touch your incisions
It will take 4 to 6 weeks to recover. Physical activity may need to be limited during this time. You may need to ask for help with daily activities and delay return to work.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever and chills
- Redness, swelling, heavy bleeding, or leaking from the incisions
- Nausea and vomiting
- Pain that you cannot control with medicine
- Problems urinating, cloudiness or pus in the urine, or a bad odor to the urine
If you think you have an emergency, call for medical help right away.
National Institute of Diabetes and Digestive and Kidney Diseases
Urology Care Foundation
Canadian Urological Association
Public Health Agency of Canada
Bellmunt J, Orsola A, et al; ESMO Guidelines Working Group. Bladder cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up. Ann Oncol 2014 Sep;25 Suppl 3:iii40.
Bladder cancer diagnosis and staging. EBSCO DynaMed website. Available at:https://www.dynamed.com/evaluation/bladder-cancer-diagnosis-and-staging. Accessed October 15, 2020.
Bladder cancer treatments. Bladder Cancer Advocacy Network website. Available at: https://bcan.org/bladder-cancer-treatment. Accessed October 15, 2020.
Last reviewed September 2020 by EBSCO Medical Review Board Elliot M. Levine, MD, FACOG Last Updated: 10/15/2020