Cystectomy (Bladder Removal): Procedure, Risks, and Recover
Asian Institute of Nephrology and Urology | Aug 26, 2024
Table Of Contents
Bladder removal surgery, or cystectomy surgery, is a MAJOR SURGICAL procedure undertaken by an experienced surgeon to treat various conditions. In most cases, it is used to treat bladder cancer. This urinary bladder surgery involves the partial or total removal of the urinary bladder and the surrounding tissues and organs, depending on the complexity of the disease. The procedure, its risks, life expectancy, and the recovery process are important aspects to consider.
As you dive deep into this article, you will explore what the condition is and how much time it takes to recover.
Bladder Removal Surgery: What Does It Mean?
Removal of the urinary bladder is primarily performed as a treatment for bladder cancer. The surgery may be divided into two types: partial cystectomy, where only a portion of the bladder gets removed, and radical cystectomy, where the entire bladder and nearby lymph nodes, or prostate, are removed. The choice of procedure clearly depends on the stage and grade of the cancer. The patient’s health is also considered before proceeding with the major surgery.
Life Expectancy After Bladder Removal: How Long Will You Live?
The life expectancy after bladder removal varies from person to person and is influenced by many factors, including the cancer stage and grade at the time of the removal surgery, the completeness of removal of the tumor, the patient’s current health, and the success of the surgery. For patients suffering from non-metastatic, muscle-invasive bladder cancer, radical cystectomy can seem curative. However, the prognosis decreases if the cancer has spread to different parts of the body. Radiation and chemotherapy might be required, and follow-ups are also recommended.
Removal of Urinary Bladder: The Procedure
The surgical removal of the urinary bladder creates a need for a substitute method for urine to be passed from the body. How else will a human being pass urine when there is no urinary bladder? Many urinary diversion techniques are used, depending on the given case and the patient's personal preferences. The most common methodologies include creating a urostomy, where urine goes out of the body through a new opening in the abdominal wall into a urostomy bag. In this method, a small part of the small intestine is refashioned as a tube to help drain the urine out. Another more complex method is creating a new bladder with the help of intestines, called a neobladder. The neobladder allows the patient to urinate normally instead of having a bag attached to the body.
Many urinary diversion techniques are used, depending on the given case and the patient's personal preferences. The most common methodologies include creating a urostomy, where urine goes out of the body through a new opening in the abdominal wall into a urostomy bag. In this method, a small part of the small intestine is refashioned as a tube to help drain the urine out. Another more complex method is creating a new bladder with the help of intestines, called a neobladder. The neobladder allows the patient to urinate normally instead of having a bag attached to the body.
The Cystectomy Procedure: How Does It Happen?
The cystectomy procedure is quite complex and can take several hours to complete, typically involving a team of specialized and experienced surgeons. The procedure starts with the administration of general anesthesia, followed by the surgical removal of the patient’s bladder.
So, in men, the procedure would require the removal of the prostate AND the seminal vesicles. In women, it would be the removal of the ovaries, uterus, and a part of the vagina.
Once the bladder and any other required organs are removed, the surgeons proceed with the urinary diversion. The surgeon will discuss everything with you before proceeding.
What Are The Risks of Cystectomy?
Like many other major surgeries, cystectomy procedures come with potential risks. These might include bleeding, infection, side effects associated with anesthesia, and complications from urinary diversion such as hernia or infection. Long-term health issues may also include urinary incontinence, stone formation in the neobladder, erectile dysfunction, and fertility changes.
Recovery from Cystectomy: How Soon Does It Happen?
Recovery from a cystectomy can be lengthy and challenging, requiring patience and care. Immediately after the cystectomy surgery, patients usually stay in the hospital for about a week to 10 days to ensure initial healing and the management of any immediate postoperative complications. Pain management, wound care, and learning how to manage the new urinary diversion are essential during this time. You start living a new life altogether right after the surgery.
Once the patient is home, recovery still involves lifestyle adjustments. Patients will need to monitor for signs of health complications, attend follow-up appointments, and adjust their diet and activity levels to accommodate their new urinary system. Support from family members, friends, and doctors is crucial during this period.
Psychological and Emotional Considerations
Undergoing bladder removal and adjusting to life afterward can have significant psychological and emotional effects. Patients may experience anxiety, depression, or feelings of grief. Support groups can be beneficial during this time. If you or a family member has undergone the surgery, it's important to be around them or encourage them to seek help from a psychiatrist or a support group.
Concluding Thoughts
A cystectomy is a major surgical intervention with significant effects on a patient's life. While it poses several risks and requires an intensive recovery period, it can also be a life-saving procedure for those with severe bladder health issues. It's important to understand the scope of the procedure and prepare for it accordingly.
Speak to a reputable surgeon about the procedure and make an informed decision. Only an experienced surgeon can perform a cystectomy safely.
Still have questions? Take a quick look at the FAQs to find the answers you're looking for.
FAQs
Most patients stay in the hospital for one to two weeks after the cystectomy surgery, depending on the type of urinary diversion and their recovery progress.
Many patients require additional treatments such as chemotherapy or radiation, especially if the bladder cancer is serious or there are concerns regarding its spread.
Urine is usually managed through one of the urinary diversions like urostomy, neobladder, or ileal conduit, which will be planned and discussed before the bladder removal surgery.
Yes, many people lead active lives after undergoing a cystectomy or urinary bladder removal. Adjustments in daily activities and lifestyle might be required, and ongoing medical support might be needed.
There are three types:
- A partial cystectomy is one in which the surgeon removes part of the patient’s bladder.
- A simple cystectomy is when the surgeon removes all of the patient’s bladder, usually
done for non-cancerous conditions.
- A radical cystectomy is when the surgeon removes all of the patient’s bladder and
surrounding lymph nodes, usually done to treat bladder cancer.
Yes, bladder removal surgery is a major surgery, and it requires lifestyle changes post-surgery.
