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Cystectomy

(Radical Bladder Removal, Partial Bladder Removal)

Pronounced: sis-TEK-toh-mee
En Español (Spanish Version)

Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

Definition

A cystectomy is a surgery to remove all or part of the bladder:

  • A radical cystectomy removes all of the bladder, nearby lymph nodes, part of the urethra, and nearby organs that may contain cancer cells.
  • A partial cystectomy removes part of the bladder.

Reasons for Procedure

Reasons for a cystectomy include:

Possible Complications

If you are planning to have a cystectomy, your doctor will review a list of possible complications. These may include:

  • Infection
  • Bleeding
  • Loss of sexual function
  • Fluid build-up in the abdominal cavity
  • Damage to other organs
  • Blockage of urine flow from the ureters to the bladder
  • Nutrition problems, depending on the bowel segments used to create a way for urine to drain
  • Blood clots
  • Reaction to anesthesia
  • Urinary incontinence

Previous surgery in the abdomen or pelvis or radiation to the area increases your risk of complications.

What to Expect

Doctors recommend that you quit smoking before surgery. You may also need to take antibiotics to prevent infection and laxatives to clean out the 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, such as:

  • Non-steroidal anti-inflammatory drugs, such as ibuprofen
  • Blood thinners
  • Anti-platelet medication

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.

Kidneys, Ureters, and Bladder

The Urinary System
Copyright © Nucleus Medical Media, Inc.

About 3–6 hours

Anesthesia will prevent pain during the surgery. Recovery is usually painful. Your doctor will give you medicine to help manage the pain.

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.

  • A stay in the intensive care unit may be needed.
  • During surgery, a tube will be placed from the nose to the stomach. It will stay there for several days. Because you cannot eat with the tube in place, you will receive IV fluids.
  • If a urine bag was attached during the surgery, you will be taught how to dispose of urine.

When you return home, do the following to help ensure a smooth recovery:

  • Difficult physical activity should be avoided for 4-6 weeks.
  • Avoid heavy lifting, straining, and sexual activity until your doctor tells you it is okay.
  • Driving and climbing stairs is usually allowed. Ask your doctor about any restrictions.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Be sure to follow your doctor's instructions.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, heavy bleeding, or discharge from the incision and/or stoma site
  • Nausea and/or vomiting
  • Pain that you cannot control with the medicines you have been given
  • Inability to urinate or difficulty urinating, extreme cloudiness or pus in the urine, a bad odor to the urine
  • Cough, shortness of breath, or chest pain

In case of an emergency, call for medical help right away.

RESOURCES:

National Kidney and Urologic Diseases Information Clearinghouse

http://kidney.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:

Bladder cancer facts. AP John Institute for Cancer Research website. Available at: http://www.apjohncancerinstitute.org/cancer/bladder.htm. Accessed July 17, 2013.

Cystectomy information binder. Johns Hopkins Medicine website. Available at: http://urology.jhu.edu/bladder/Cystectomy.pdf. Accessed July 17, 2013.

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 July 2013 by Adrienne Carmack, MD; Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.