Cystectomy, a surgical procedure that removes part or all of the bladder, most often a surgeon implements it because of a diagnosis of bladder cancer. This surgery also treats congenital disabilities that have an impact on the urinary system. In some cases, a cystectomy treats an injury that happened to the bladder, and it also treats neurological disorders that hurt the urinary system. Because this surgery has many complexities, a lot of surgeons will use differing techniques to perform a cystectomy.
What Is a Cystectomy?
This complex procedure used to require an open surgery with a long incision to the reach the bladder, but as said before, the surgical techniques and even the special surgical tools will vary from surgeon to surgeon. In some cases, the robotic laparoscopic form of surgery means the surgeon will make several small, precise incisions using special tools to reach the bladder.
The least invasive procedure, robotic surgery, is a minimally invasive procedure where the surgeon will use remote surgical tools and several small dime size incisions. Whenever taking out the bladder entirely, surgeons will put in extra time to reconstruct the urinary tract and let urine leave the body.
For the surgical reconstruction of the bladder, the surgeon might take part of the intestine and re-purpose into a tube to run from the kidneys to the abdominal wall. The bag worn in the abdomen collects the urine, and it has been called a urinary conduit.
The Different Types of Cystectomy
You have two main types of surgery. First, you have a partial cystectomy, which removes one part of the bladder. Most often, this form of surgery gets used to treat cancer that infiltrated the bladder wall in one area, and it has not gotten bad enough to where it requires a full removal of the bladder. This surgery normally makes sense when cancer is not growing close to where the urine leaves or enters the bladder.
Second, you have a radical cystectomy where you have to remove the entirety of the bladder, the lymph nodes, and the urethra. In some cases, even the nearby organs could have experienced damage from the spread of cancer. If you’re a male with bladder cancer, the seminal vesicles, the prostate, and the vas deferens might be removed as a precaution.
For women, the uterus, the cervix, the ovaries and the fallopian tube might be removed. Whenever a person undergoes this surgery, the surgeon will have to recreate a new path for the patient to pass urine.
Who Needs a Cystectomy?
Most often, this form of surgery treats early stage bladder cancers where a tumor has the least likelihood of spreading to other parts of the body. In some cases, surgery may happen for a recurring bladder cancer. Sometimes a surgeon will recommend an alternative to preserve the bladder.
Other times the surgeon will urge you to remove the entire bladder because it reduces the risk of the cancer returning. The doctor will look at the stage of the disease and give a diagnosis before they follow through with a plan of action.
Risks Involving a Cystectomy
Unfortunately, complications have become common after a patient undergoes a Cystectomy. In particular, the radical form of surgery will come with even higher risks, and it could include anything from short-term to long-term problems. Some of the short-term issues include:
- Bowel obstruction.
- Kidney infection.
- Leaking stool or urine.
Some of the long-term issues include:
- Kidney problems.
- Renal failure.
- Obstruction of the intestines.
- Scar tissue within the intestines.
- Issues with the newly created opening.
Recovery Process & Period
After the surgeon performs a cystectomy, you will normally stay in the hospital for four days to one week. During the first several days, you can expect your body to experience some discomfort as it goes through the healing process. In most cases, you can control the pain with medicine and home treatment. For a full recovery, you can expect it to take between six to eight weeks.
While in recovery, a doctor will usually prescribe you some pain medication like Oxycodone or Vicodin. Along with pain medications, you might also be prescribed a medication to help avoid constipation. Important to note, you will normally have to sit and stand as early as the day after surgery to prevent serious complications like blood clots and pneumonia.
As you recover from surgery, you must stay active and walk every day as part of the aid in the healing process. This also increases your muscle tone and decreases your risk depressed mood. It takes around six weeks before the surgical area heals completely, and during this time you should avoid strenuous exercises and heavy lifting. After three to four weeks out from surgery, you may drive a car.
Alternatives to a Radical Cystectomy
The above surgery has become the preferred treatment for patients. However, some cases have used chemoradiotherapy as a treatment for bladder cancer. Although, the majority of patients will undergo a radical cystectomy, there are cases where bladder sparing chemoradiotherapy will be recommended.
Drawing to a Close
These are some of the things you could expect from a cystectomy. If you have bladder cancer, this surgery could be in your best interest, depending on the circumstances. However, the best way to find out is to talk with your doctor to learn about the best treatment option for you. It is exceptionally important that those who believe they may have bladder cancer to speak with their doctor to get an accurate diagnosis and treatment plan.