Cystectomy

Cystectomy is a procedure that is used to remove part of or the whole bladder. It is used in the treatment of bladder cancer.  

Cystectomy may be used in the treatment of the following:

• Cancer that begins in the bladder or cancer that begins in a nearby organ and grows to involve the bladder.
• Birth defects that have an effect on the urinary system.
• Traumatic injuries to the bladder.
• Neurological disorders that affect the urinary system.

Cystectomy is a cumbersome procedure and there are different types of techniques at a doctor’s disposal, such as:

Open surgery. This procedure requires one long incision to get to the bladder.

Minimally invasive surgery. This procedure involves several small incisions where special surgical tools are inserted to access the bladder.

Robotic surgery. This is a type of minimally invasive procedure in which the surgeon sits at a console and remotely operates the surgical tools.

In a case where your bladder is completely removed, surgeons work to construct the urinary tract in order to allow urine to leave your body. Several operations exist:

Urinary conduit (ileal conduit or urostomy). During this operation, the doctor will make use of a piece of your intestine to create a tube that runs from your kidneys o your abdominal wall. A bag you wear on your abdomen collects the urine.

Cutaneous continent urinary diversion (Indiana pouch). In this procedure, the surgeon uses a piece of your intestine to create a tube that runs from your kidneys to a small reservoir that is attached to the inside of you abdominal wall. You use a catheter to empty the reservoir several times a day.

Orthotropic continent urinary diversion (neobladder). During this procedure, the surgeon uses a piece of tour intestine to create a tube that runs from your kidneys to a small reservoir that allows you to urinate through your urethra in a relatively normal way.

What type of cystectomy and reconstruction you undergoes will depend on several factors, such as the reason for your surgery, your overall health, and your preferences. Discuss your options with your surgeon to determine your best option.

Discuss your options with your surgeon to determine your best option.

The main reason for a cystectomy is when cancer has developed in the wall of the bladder or as recurred after a previous treatment.

The following risks can be associated with cystectomy:

• Kidney infection.
• Leaking of urine or stool.
• Bowel obstruction.
• Acidosis s an imbalance in electrolytes such as calcium and potassium. It can be a result of using part of the intestine to divert urine after a cystectomy. Individuals with this condition need medication to help suppress it. Acidosis is usually a short-term problem.

Other problems associated with cystectomy include:

• Obstruction of the ureters or intestines.
• Problems with the newly created opening (stoma).
• Kidney problems, such as renal failure.
• Scar tissue that forms inside the intestines (strictures).

The above are long-term risks.

Understanding the results of your cystectomy (bladder removal surgery) will be made possible by your doctor.

After cystectomy, you will likely stay in the hospital for about a week.

You will be in discomfort for the first few days after the surgery, a discomfort which can be controlled with home treatment and medications.

A full recovery usually takes a period of about 6 to 8 weeks. You may require more treatment after a radical cystectomy which may include radiation therapy or chemotherapy.

After the initial treatment for bladder cancer, you must make sure you co for follow-up care. Your doctor will arrange a schedule for checkups and tests.