What Happens During Cystectomy for Bladder Cancer

The night before the surgery, you will need to drink liquid medicine that empties your bowels. You will also need to have a liquid-only dinner. And you may take an antibiotic to reduce the chance of infection. If you are healthy, you can check into the hospital on the same day of your surgery.

What Happens During a Radical Cystectomy for Bladder Cancer

Surgical boundaries of radical cystectomy in a man. The specimen includes the bladder, the prostate, and the seminal vesicles.

In the operating room, you are given a general anesthesia that puts you to sleep and keeps you from feeling pain.

The surgeon makes a cut in your abdomen in order to reach the bladder. The surgeon first checks the lymph nodes near the bladder to see if the cancer has spread. Your surgeon may take out some of the lymph nodes to see if they contain cancer.

After that, your surgeon takes out your bladder. And, depending on where the cancer is, the surgeon may also remove your urethra.

Surgical boundaries of radical cystectomy in a woman. The specimen includes the bladder and entire urethra, uterus, ovaries, fallopian tubes, and the anterior wall of the vagina.

Your surgeon will look for signs of cancer in other nearby organs and determine how likely it is that these nearby organs might be involved. If you’re a man, your surgeon checks your prostate gland and will remove it if the cancer has spread to this area.  If you’re a woman, your surgeon checks your uterus, ovaries, fallopian tubes, and a small part of your vagina and will remove them if the cancer has spread to these areas.

After removing the bladder, the surgeon creates a new way for urine to be stored and to leave the body. This procedure is called reconstructive surgery. The whole procedure--to remove the bladder and make a new way for urine to exit your body--may take 4 to 8 hours. 

What Happens During a Partial Cystectomy

It may not be necessary to remove your whole bladder. If that’s the case, your surgeon may do a procedure called partial cystectomy. For that, only the wall of the bladder containing the cancer is cut out. If you have this procedure, your doctor will probably recommend additional treatments with chemotherapy or radiation to kill any cancer cells that may be left. Your surgeon may know ahead of time if partial cystectomy is the right approach for your kind of cancer. In some cases, the surgeon won’t know for sure if this is an option until the surgery is in process.

Your surgeon will also look for signs of cancer in other nearby organs and determine how likely it is that these nearby organs might be involved. If you’re a man, your surgeon checks your prostate gland and will remove it if the cancer has spread to this area. If you’re a woman, your surgeon checks your uterus, ovaries, fallopian tubes, and a small part of your vagina and will remove them if the cancer has spread to these areas. This procedure takes 3 to 4 hours.