Bladder removal surgery (cystectomy)

Cystectomy (sis-TEK-tuh-me) is a surgery to remove the urinary bladder. Removing the whole bladder is called a radical cystectomy. This most often includes removal of the prostate and seminal vesicles or the uterus, ovaries, fallopian tubes and part of the vagina. After removing the bladder, a surgeon also needs to make a new way for the body to store urine and for urine to leave the body. This is called urinary diversion. A surgeon talks about the choices for urinary diversion that may be right for you.

You may need bladder removal surgery, also called cystectomy, to treat: Cancer that begins in or spreads to the bladder. Issues with the urinary system present at birth. Conditions of the nervous system, called neurological conditions, or inflammatory conditions that affect the urinary system. Complications from treatments for other cancers, such as radiation, that cause issues with the bladder. The type of cystectomy and new storage that you have depends on many things. These include the reason for surgery, your overall health, what you want and your care needs.

Cystectomy is a complex surgery. Cystectomy risks include: Bleeding. Blood clots. Infection. Poor wound healing. Damage to nearby organs or tissues. Organ damage due to the body reacting poorly to infection, called sepsis. Rarely, death linked to complications from surgery. Other risks linked to urinary diversion depend on the procedure. Complications may include: Ongoing diarrhea. Decline in kidney function. Imbalance in needed minerals. Not enough vitamin B-12. Urinary tract infections. Kidney stones. Loss of bladder control, called urinary incontinence. A blockage that keeps food or liquid from passing through the intestines, called a bowel obstruction. A blockage in one of the tubes that carries urine from the kidneys, called ureter blockage. Some complications may be life-threatening or lead to being in the hospital. Some people may need another surgery to correct problems. Your surgical team tells you when to call your care team or when to go to the emergency room during your recovery.

Before your cystectomy, you talk to your surgeon, your anesthesiologist and other members of the care team about your health and any factors that may affect the surgery. These factors may include: Long-term medical conditions. Other surgeries you've had. Medicine allergies. Earlier reactions to anesthesia. Stops in breathing during sleep, called obstructive sleep apnea. Also review with the surgical team your use of the following: All the medicines you take. Vitamins, herbal medicines or other dietary supplements. Alcohol. Cigarettes. Illicit drugs. Caffeine. If you smoke, talk to a member of your healthcare team about what help you need to quit. Smoking can affect your recovery from surgery and can cause problems with the medicine used to put you to sleep, called anesthesia.

Choices for cystectomy surgery include: Open surgery. This approach uses a single cut, called an incision, on the belly to get to the pelvis and bladder. Minimally invasive surgery. With minimally invasive surgery, the surgeon makes several small cuts in the belly. The surgeon then puts in special surgical tools through the cuts to work on the bladder. This type of surgery also is called laparoscopic surgery. Robotic surgery. Robotic surgery is a type of minimally invasive surgery. The surgeon sits at a console and moves robotic surgical tools.