Cystectomy
Cystectomy is the surgical removal of the urinary bladder. During radical cystectomy, the entire bladder is removed. During a partial cystectomy, a cancerous tumor is removed in an isolated portion of the bladder.
In men, a cystectomy typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy involves removal of the uterus, ovaries, fallopian tubes, and part of the vagina.
After removing the bladder, your surgeon will create a new way to store and release urine from the body, a procedure called urinary diversion.
Reasons for a Cystectomy
Cancer that begins in or spreads to the bladder
Neurological or inflammatory disorders that affect the urinary system
The type of cystectomy that is done depends on the purpose of surgery, the patient’s overall health, and their preferences.
Potential Risks of Cystectomy
Cystectomy is a complex surgery that requires manipulation of many internal organs in the abdomen. The procedure’s complexity can lead to certain risks, including:
Infection
Bleeding
- Blood clots that travel to the lungs or heart
- Blood clots in the legs
- Poor wound healing
- Damage to nearby organs or tissues
- Organ damage due to the body’s overreaction to infection (sepsis)
- Dehydration
- Decline in kidney function
- Imbalance in essential minerals
- Vitamin B-12 deficiency
- Urinary tract infection
- Kidney stones
- Loss of bladder control (urinary incontinence)
- A blockage that keeps food or liquid from passing through your intestines (bowel obstruction)
- A blockage in one of the tubes that carries urine from the kidneys (ureter blockage)
Surgery Options
Cystectomy may be performed through the following methods:
Open surgery: When using this approach, the surgeon makes a single incision in the abdomen to access the pelvis and bladder.
Minimally invasive/robotic surgery: During minimally invasive surgery, the surgeon makes several small incisions in the abdomen and inserts special surgical tools through the incisions. This type of surgery is also called laparoscopic surgery. With robotic surgery, surgical tools are controlled by the surgeon sitting at a console.
What to Expect During the Procedure
The patient will be given a general anesthetic that will keep them asleep during the procedure. Once the patient is asleep, the surgeon will cut into the abdomen. One large incision will be made during open surgery. A few smaller incisions will be done during minimally invasive or robotic surgery.
Next, the surgeon will remove the bladder. If the cystoscopy is being done to treat bladder cancer, the surgeon will also remove nearby lymph nodes, which are part of the immune system. These will be evaluated in a lab to identify the presence of cancer.
The Recovery Process
After surgery, patients may experience sore throat, shivering, sleepiness, dry mouth, nausea and vomiting. Medications may be prescribed to alleviate these symptoms. It may take a while for normal bowel function to return, potentially delaying recovery after a radical cystectomy.
