Bladder Removal Surgery

Cystectomy Bladder Removal Procedure

The medical name for a bladder removal procedure is a cystectomy. The term cystectomy can apply to removal of the entire bladder, or removal of a part of it. The most common reason for a bladder removal procedure is bladder cancer.

Bladder removal due to cancer When a diagnosis of bladder cancer occurs, your doctor will run tests to find out how far the cancer has progressed. For bladder cancer, stages are listed from Stage 0 to Stage IV, with Stage IV being the most advanced.

Individuals who have reached bladder cancer stage II or stage III are candidates for full bladder removal surgery, although it may still be possible to do a partial bladder removal.

The procedure for removing the entire bladder is known as a radical cystectomy, and it also involves removing other tissues and organs. In men, the prostate and seminal vesicles are removed. In women, a radical cystectomy includes removal of the uterus, ovaries and part of the front wall of the vagina. Men are rendered impotent, although whenever possible the surgeon will try to spare the nerves necessary for an erection. Women become infertile, and removing the ovaries causes premature menopause if the woman has not begun menopause already. The surrounding lymph nodes are usually removed as part of the operation.

Bladder removal surgery is a complex surgical procedure that must be done in a hospital. General anesthesia is required for the operation, which generally takes about three hours. The hospital stay will normally last a week to ten days.

Bladder replacement options When you have a complete bladder removal procedure, your surgeon has to fashion a replacement so that you can continue to process urine.

One method is called the ileal conduit urinary diversion. This is done by surgically resecting ureters from the bladder and attaching them to a section of the small intestine known as the ileum. The surgeon diverts the end of the ilium through the abdominal wall. Urine collects in a bag outside the body. The bag must be emptied when needed, and it also must be replaced regularly - every week or so.

There's also a variation of this method called the continent urinary reservoir. The surgeon, in effect, creates a replacement bladder (called a neobladder) by taking a section of the ileum or colon and forming it into a pouch. When this pouch is connected to the ureters and urethra, it replaces the bladder that was removed. Urine comes into the pouch from the kidneys in basically the same way it did before. The patient can release the urine by straining his or her abdominal muscles.

While this alternative sounds much more appealing, it's important to note that there are side effects. The digestive system partially shuts down because part of the intestine has been removed. Plus, some loss of bladder control can also become commonplace because the nerves that previously told you your bladder was full are no longer there.

After bladder removal complications Bladder removal surgery requires follow up radiation therapy and chemotherapy. This decreases the risk that the cancer may return.

As with all surgical procedures, there's a possibility of bleeding or infection. Blood clots and bowel obstruction are also possible. Some patients report severe diarrhea after bladder removal surgery. This is probably the result of post-op antibiotics, which not only kill bad bacteria, but sometimes kill the "good" bacteria in our digestive systems.

Keep in mind, a bladder removal procedure is a major operation, and you don't return to normal in a day or two. Communicate closely with your doctor and understand that your recovery will take some time.

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