Cystectomy
Overview
A cystectomy is a surgical procedure to remove all or part of the urinary bladder. It is commonly performed to treat muscle-invasive bladder cancer, severe bladder dysfunction, or certain benign but serious bladder diseases.
Types of Cystectomy
1. Partial Cystectomy
- Only the diseased portion of the bladder is removed.
- Usually done when cancer is small and localized.
2. Radical Cystectomy
- Entire bladder is removed.
- Nearby organs may also be removed:
- In men → prostate, seminal vesicles
- In women → uterus, ovaries, part of vagina
Urinary Diversion Options
After bladder removal, a new pathway for urine is created:
1. Ileal Conduit (Urostomy)
- A piece of intestine is used to create a tube that drains urine into an external bag.
2. Continent Cutaneous Reservoir
- Internal pouch created from intestine; patient empties it with a catheter.
3. Neobladder
- A new bladder is made from intestine.
- Allows urination through the urethra.
When is Cystectomy Needed?
- Muscle-invasive bladder cancer
- High-grade recurrent bladder cancer
- Severe interstitial cystitis
- Significant bladder dysfunction
- Traumatic bladder injury
- Rare congenital abnormalities
Recovery & Post-Surgery Care
- Hospital stay: 5–10 days
- Catheter/drain management
- Learning how to manage the urinary diversion
- Avoid heavy lifting for 6–8 weeks
- Follow-up imaging and urine tests
- Long-term rehabilitation for neobladder training
Risks & Complications
- Infection
- Bleeding
- Blood clots
- Difficulty urinating
- Sexual dysfunction
- Bowel complications
- Electrolyte imbalance