Bladder Removal Surgery (Cystectomy): Types, Benefits & Complications

Bladder Removal Surgery (Cystectomy): Types, Benefits & Complications

Cystectomy is the partial or entire removal of the urinary bladder. Patients with cancerous or non-cancerous growths in the urinary bladder  may have to undergo cystectomy 

What Is Cystectomy?

Your surgeon, during cystectomy, removes the bladder including part of the urethra, together with nearby lymph nodes.

Radical cystectomy  (removing the entire bladder), in men typically includes removal of the seminal vesicles and prostate. Radical cystectomy in women involves removal of the ovaries, uterus and part of the vagina.

After removing your bladder, your surgeon has to create a urinary diversion, a new way to store urine and make it leave your body. There are many ways urine can be stored and eliminated after removal of the bladder. Your surgeon can help decide which method is best for you.

cystectomy is often performed to treat recurrent noninvasive or invasive bladder cancer. Cystectomy can also be done to treat other pelvic tumors like prostate, endometrial and advanced colon cancer including some benign (noncancerous) conditions like interstitial cystitis or congenital abnormalities.

When do you need a Cystectomy?

Cystectomy is a complex surgery. It involves removal of the urinary bladder and concurrently creating a new path to pass urine. 

Connect with your doctor to know if a cystectomy can treat your condition.

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Why Is Cystectomy Performed?

Cystectomy is a surgical procedure that helps patients with the following conditions.

• Cancerous growth in the urinary bladder
• Cancerous growth outside the bladder that grows into the bladder
• Defects in the urinary system from birth
• Disorders that may adversely affect the urinary bladder
• Non-cancerous growths in or out of the urinary bladder

Your doctor can help you understand if you require a cystectomy .

What Are the Different Types of Cystectomy?

You may undergo any of the following types of cystectomy:

Radical Cystectomy

Radical cystectomy or a total cystectomy requires removing the urinary bladder and some other neighboring organs. 

A radical cystectomy will mean removing the urinary bladder, prostate, vas deferens, and seminal vesicles in men. In women, the surgery may remove the bladder, along with the uterus, ovaries, fallopian tubes, cervix, and some parts of the vagina. 

Partial Cystectomy

In some cases where the tumour or disease is localized or in cases where a  radical cystectomy may seem impossible due to health concerns, a partial cystectomy is done wherein a part of the urinary bladder is removed. 

Whether partial or radical, cystectomy is performed in the following two ways.

Traditional open surgery

Doctors make an incision in the lower middle section of your abdomen to reach out to the pelvic area and perform the surgery. 

Minimally invasive surgery

Minimally invasive surgery can be of two forms.

1. Laparoscopic Cystectomy

Your surgeon makes several small incisions on your abdomen where special surgical tools are inserted to access the abdominal cavity.

2. Robotic Cystectomy

The doctor sits at the console giving directions and performing the surgery through special surgical tools.

All the above types of surgery require general anesthesia. After the procedure, you may need to stay in the hospital for at least five to seven days. 

What Are the Benefits of a Cystectomy?

Cystectomy helps remove tumours  in your urinary bladder and treat other diseases of the bladder. The key benefit of performing a cystectomy to remove the bladder is that there are high chances of your recovery and regaining better health.

What Are Some Complications Associated With a Cystectomy?

Cystectomy is a major surgery. It involves removing the urinary bladder and then reconstructing the path to pass urine. It may pose some complications after the surgery, demanding immediate attention.

Some complications include:

• Excessive bleeding
• Infections at the site
• Postoperative pain
• Chest infections leading to pneumonia
• Deep vein thrombosis

Since cystectomy involves the resurrection of an alternate path for urine passing, it may also cause some late complications. These may include:

• Urinary tract infection
• Extreme dehydration
• Electrolyte abnormalities
• Inflammation of urine outlet
• Bowel obstruction
• Stones in the bladder

However, frequent follow-ups with your doctor will help you recognize these in the initial stages and get the necessary treatments. 

Frequently Asked Questions (FAQs)

Does robotic surgery to remove the urinary bladder have any advantage?

Robotic surgery offers multiple benefits, and doctors throughout the world prefer the technique for precision. The advantages include:

• Better visualization of the organ
• No need to constantly move the patient to view the parts
• Better visibility means precise dissection of organs and less blood loss
• Ergonomic grip and comfortable movement of surgical equipment

What is the mortality rate after cystectomy?

Since cystectomy is a major surgery,  complications and mortality can occur primarily due to cardiovascular complications, infections, or recurrence of cancer. 

What are the alternative ways of urine passage?

Once the urinary bladder is removed, your surgeon will reconstruct the urinary tract to allow urine passage. There are several methods for the procedure, such as the ileal conduit, neobladder construction, or continent urinary reservoir construction.