Cystectomy
Topic at a Glance
- A cystectomy removes part or all of the urinary bladder and may be used to treat bladder cancer.
- Radical cystectomy removes the entire bladder and nearby lymph nodes and is commonly used for muscle-invasive bladder cancer.
- After bladder removal, urinary diversion creates a new way for urine to leave the body.
- Recovery takes time, but many patients can gradually return to daily activities with appropriate follow-up care.
When cancer affects the urinary bladder, a surgical procedure called a cystectomy may be recommended depending on the cancer’s stage, location, size, and other individual factors. In this article, we will explain what a cystectomy is, what to expect from bladder cancer surgery, and the different options for urinary diversion following bladder removal surgery.
If you have been diagnosed with bladder cancer or are considering bladder cancer surgery, contact Urology of Greater Atlanta to discuss your options with an experienced urologist. Our practice has many locations throughout Georgia, and all doctors on staff are board certified.
What Is a Cystectomy?
A cystectomy is bladder removal surgery. Depending on the cancer and the patient’s circumstances, a surgeon may perform a partial cystectomy, which removes only part of the bladder, or a radical cystectomy, which removes the entire bladder.
What Should I Expect From a Cystectomy?
During a cystectomy, the surgeon removes the bladder and may remove nearby lymph nodes to determine whether cancer has spread. The surgeon then creates a new pathway for urine through a type of urinary diversion.
After the bladder is removed, the urinary system must be reconstructed. Your surgeon will discuss which type of urinary diversion best fits your health, anatomy, cancer treatment, and lifestyle.
Ileal Conduit
An ileal conduit uses a short section of the small intestine to create a passageway for urine. The ureters, which carry urine from the kidneys, are connected to this section of intestine. The other end is brought through an opening in the abdominal wall called a stoma.
Urine continuously drains through the stoma into an external collection bag. The bag is emptied regularly and does not require the patient to control urine flow. This is a commonly used type of urinary diversion after radical cystectomy.
Neobladder Reconstruction
A neobladder uses a section of the intestine to create a new reservoir in the location of the original bladder. The neobladder is connected to the ureters and, when appropriate, the urethra, allowing urine to leave the body through the urethra.
Patients generally need to follow a regular schedule for emptying the neobladder because normal bladder sensations may change. Some patients may experience urinary leakage or may need to use a catheter to completely empty the reservoir.
Continent Urinary Reservoir
A continent urinary reservoir is another reconstruction option. The surgeon creates an internal pouch from a section of intestine and connects it to a stoma. Unlike an ileal conduit, the reservoir stores urine inside the body.
The patient periodically inserts a thin tube, called a catheter, through the stoma to empty the reservoir. This option eliminates the need for a continuously worn external collection bag, although it requires regular catheterization and ongoing care.
Recovery After a Cystectomy
Recovery after a cystectomy varies based on the type of operation, urinary diversion, overall health, and whether additional bladder cancer treatment is needed. Because this is major surgery, patients generally spend several days in the hospital and may need several weeks before returning to normal activities.
During recovery, your care team will monitor your incision, urinary diversion, bowel function, and ability to stay hydrated and active. You may also learn how to care for a stoma, manage a urinary collection bag, or use a catheter, depending on your type of urinary diversion.
Potential complications can include bleeding, infection, blood clots, injury to nearby organs, urinary leaks, urinary tract infections, and changes in urinary function.
Schedule an Appointment Today
If you are considering bladder cancer surgery, schedule an appointment with Urology of Greater Atlanta to discuss your diagnosis and treatment options. Urology of Greater Atlanta has many convenient locations throughout Georgia, and all doctors on staff are board certified. Contact our practice today to take the next step toward personalized urologic care.
FAQs About Cystectomy
Is a cystectomy always used to treat bladder cancer?
No. Treatment depends on the cancer’s stage, grade, location, and other factors. Some patients may be treated with procedures such as transurethral resection or intravesical treatments, while others may need partial or radical cystectomy.
What is the difference between a partial and radical cystectomy?
A partial cystectomy removes part of the bladder, while a radical cystectomy removes the entire bladder. Partial cystectomy is used only in carefully selected cases, while radical cystectomy is commonly used for muscle-invasive bladder cancer.
What happens after the entire bladder is removed?
When the entire bladder is removed, the surgeon creates a urinary diversion. Options may include an ileal conduit, neobladder reconstruction, or a continent urinary reservoir.
How long does it take to recover from cystectomy?
Recovery varies from person to person. Hospitalization typically lasts several days, and returning to normal activities may take several weeks. Your surgeon will provide individualized instructions based on your procedure and recovery progress.
Can cystectomy be performed using minimally invasive surgery?
Yes. Some cystectomies can be performed using laparoscopic or robotic techniques. Whether minimally invasive surgery is appropriate depends on the patient’s cancer and individual circumstances.
