If you or a loved one is facing a cystectomy, this guide explains everything—from types and preparation to recovery and life after surgery.
A cystectomy is a surgical procedure to remove all or part of the bladder, typically due to bladder cancer, severe dysfunction, or chronic conditions. This surgery can be life-saving but also life-changing, requiring adjustments in urinary function. Understanding what to expect can ease anxiety and help patients prepare physically and emotionally.
Bladder removal may sound daunting, but advancements in surgical techniques and post-operative care have improved outcomes significantly. Whether you’re considering a partial or radical cystectomy, this guide will walk you through the process, risks, and recovery tips to help you make informed decisions.
This surgery is often recommended when other treatments fail, especially for muscle-invasive bladder cancer. Early consultation with a urologist ensures the best approach tailored to your health needs.
Partial Cystectomy: Only the diseased portion of the bladder is removed, preserving urinary function. This is rare and suitable for small, localized tumors. Recovery is faster, but frequent monitoring is needed to prevent recurrence.
Radical Cystectomy: The entire bladder, nearby lymph nodes, and sometimes adjacent organs (prostate in men, uterus/ovaries in women) are removed. This is standard for aggressive cancers. After removal, urinary diversion (e.g., ileal conduit or neobladder) is required.
The choice depends on cancer stage, overall health, and patient preference. Robotic or laparoscopic methods (minimally invasive) may reduce scarring and recovery time compared to open surgery.
The most common reason is bladder cancer, especially if tumors invade the muscle layer or resist other treatments like chemotherapy or immunotherapy. Other reasons include:
Doctors weigh risks versus benefits carefully. For non-cancer cases, alternatives like catheterization or medications are tried first.
Medical Evaluation: Blood tests, imaging (CT/MRI), and cardiac/pulmonary assessments ensure you’re fit for surgery. Smoking cessation is critical to reduce complications.
Diet & Bowel Prep: You may need a clear-liquid diet and laxatives to empty the intestines, especially if urinary diversion is planned.
Mental Preparation: Meet with a stoma nurse (if applicable) to discuss post-surgery care. Arrange help for household tasks during recovery.
Pre-Op Instructions: Fasting 12 hours before surgery and stopping certain medications (e.g., blood thinners) may be required.
1. Anesthesia: General anesthesia ensures you’re asleep and pain-free.
2. Incision: For open surgery, a single abdominal cut is made. Laparoscopic/robotic methods use small keyhole incisions.
3. Bladder Removal: The bladder is detached from surrounding tissues and blood vessels. In radical cystectomy, nearby organs may also be removed.
4. Urinary Diversion: A new way to pass urine is created—options include an external ostomy bag (ileal conduit) or an internal pouch (neobladder).
5. Closing: Incisions are stitched, and drains may be placed to remove excess fluids.
Surgery takes 3–6 hours, depending on complexity.
Hospital Stay: Typically 5–10 days. Pain is managed with medications, and walking is encouraged to prevent blood clots.
Catheters/Drains: You’ll have temporary catheters to drain urine and surgical fluids. Nurses will teach you how to care for them.
Diet: Start with liquids, then soft foods as bowel function resumes. Hydration is vital to prevent UTIs.
Activity: Avoid heavy lifting for 6–8 weeks. Gradually increase light activities like walking.
Follow-Up: Regular check-ups monitor healing and cancer recurrence (if applicable).
Most complications are manageable with prompt medical attention.
Physical Activity: Most patients return to normal activities within 3 months, though contact sports may be restricted.
Diet: No strict limits, but some notice changes in digestion (e.g., vitamin B12 deficiency with ileal conduit).
Emotional Health: Support groups or counseling can help cope with body image changes.
Travel: Carry extra ostomy supplies if applicable. Stay hydrated to avoid kidney stones.
Many live full, active lives post-surgery with proper care.
Is cystectomy the only option for bladder cancer?
No—early-stage cancers may be treated with tumor removal, immunotherapy, or radiation. Cystectomy is typically for advanced cases.
Will I need a bag after surgery?
Not always. Neobladders allow internal urine storage, while ileal conduits require an external pouch. Your surgeon will discuss options.
How long does recovery take?
Full recovery takes 3–6 months, but most resume light activities within weeks.