Cystectomy

Cystectomy is surgery to remove the urinary bladder. It may be done in certain cases of bladder cancer. Your healthcare provider can discuss the risks and benefits of the surgery with you.

In men, the bladder, lymph nodes, prostate and often the urethra are removed.	In women, the bladder, uterus, cervix, lymph nodes, urethra and sometimes part of the vagina are removed.

Preparing for surgery

You will be told how to prepare for surgery. These instructions may include:

• Donating your own blood a few days before the surgery. This is in case you need a transfusion during the surgery.
• Taking antibiotics before surgery. This is to help prevent infection.
• Not eating or drinking anything for a certain amount of time before surgery.
• Clearing your intestine. You may do this by drinking a special liquid at home.
• You may be admitted to the hospital the night before surgery and be given medicine and enemas to empty the intestine. 

Removing the bladder

• The surgery is done in a hospital and takes a few hours.
• Just before surgery, you will be given medicine called general anesthesia to put you into a sleep-like state and to prevent pain during the surgery.
• A cut (incision) is then made near your belly button. This exposes the bladder.
• The area around your bladder is checked to see if the cancer has spread. If it has, the surgery may not be continued.
• If the cancer is only in the bladder, the bladder is removed. Other organs near the bladder may be removed as well. This is in case cancer cells may have spread to those organs.

 Creating a new path for urine

After the bladder is removed, you will need a new way to store and release urine.  There are 3 different options to accomplish this task. Talk to your healthcare provider about which option would be best for you. 

The options include:

• Incontinent diversion: A short piece of intestine is removed and connected to the ureters while the other end is connected to the skin on the front of the belly (abdomen).  This forms an opening called a stoma. This procedure is called a urostomy. A small bag is placed over the stoma to collect the urine. 
• Continent diversion: A valve is created in a pouch made from a piece of intestine. You can empty the pouch several times a day by putting a drainage tube (catheter) into the stoma through the valve. This method does not need a collection bag.  
• Neobladder: A new bladder is made from a piece of intestine and urine is routed back into the urethra, restoring urination. Over time most people are able return to normal urination during the day but many may still have incontinence at night.   

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