What is a Cystectomy?

A cystectomy is a surgical operation performed to remove a person’s bladder. The urinary bladder is the pelvic organ that stores urine until it leaves the body. Depending on the reason for the cystectomy, the surgery may involve removing a patient’s entire bladder or just part of it. When the entire bladder is removed, the procedure is called a simple cystectomy; if only a portion is removed, it’s called a partial cystectomy. In some cases, it is necessary or beneficial to remove other organs in the pelvis along with the bladder, and that procedure is called a radical cystectomy.

This surgery is typically used as a treatment for bladder cancer, though it may be performed to treat other serious health problems that involve the bladder as well. Since a cystectomy is major surgery, the patient is usually given general anesthesia. Once the patient has been prepared for surgery and the anesthesia has done its job, a surgeon makes an incision in the patient’s abdomen and removes all or part of the bladder through it.

Following surgery, a patient who has undergone a cystectomy will have some major adjustments to make. Since his bladder can no longer hold urine until he is ready to urinate, he will need a new way to eliminate urine. For this purpose, surgeons create a urinary diversion.

One type of urinary diversion following cystectomy involves removing a piece of the patient’s intestine and tying it at one end, creating a tube-like piece. The untied end is used to create an opening that leads from the abdominal wall to the outside of the body. Then, the tube is connected to the patient’s ureters, which are tubes through which urine moves to the bladder from the kidneys. When urine moves from the patient’s kidneys following this type of diversion, it will flow through the ureters and through the tube, finally flowing from the hole in abdominal wall to a bag the patient wears to hold it.

Like all surgeries, cystectomy represents some risks for the patient. Among the most serious is infection of the intestines. Such infection can contribute to the development of a condition called peritonitis, a life-threatening condition marked by inflammation of the membrane that lines the abdomen. Also, when only part of the bladder has been removed, a patient’s urine may leak from the bladder into the body. Besides these potential problems, a patient could lose too much blood, have anesthesia-related problems, sustain damage to other organs, or experience sexual-performance difficulties after recovering from surgery.