Cystectomy

Procedures we perform
ABOUT CYSTECTOMY

What is a cystectomy?

A cystectomy is a procedure to remove the urinary bladder.

After the bladder is removed, the flow of urine is usually diverted into a segment of bowel which is brought out onto the skin on the abdomen as a stoma. This is known as an ileal conduit. Urine drains from the ileal conduit into a stoma bag worn on the abdomen.

Alternatively, it is sometimes possible to create a new bladder out of a segment of bowel, which is connected to the urethra (waterpipe). This is known as a neobladder.

Why is a cystectomy required?

Cystectomy is usually performed to treat aggressive bladder cancer.

Removing the bladder for cancer is known as a radical cystectomy.

Occasionally cystectomy is performed for non-cancerous conditions, such as when the bladder has been severely damaged by inflammation or radiation therapy and is causing pain, bleeding, or recurrent infections.

Removing the bladder for a non-cancerous condition is known as a simple cystectomy.

 

Read more about these conditions below.

Bladder Cancer

Bladder cancer is a disease caused by the abnormal growth of cells in the bladder. It occurs when cells from the lining of the bladder (known as the urothelium), grow uncontrollably, forming a tumour that can spread to other parts of the body.

Blood in urine

Blood in urine, also known as haematuria, causes the urine to look red, pink, or cola-coloured.

Urinary tract infections

A urinary tract infection (UTI) is an infection that occurs in any part of the urinary system, which includes the kidneys, ureters, bladder, and urethra. Most UTIs involve the lower urinary tract, specifically the bladder and urethra.

Bladder pain syndrome (Interstitial cystitis)

Bladder pain syndrome (BPS), formerly known interstitial cystitis (IC), is a condition which causes pelvic pain and urinary symptoms, including urinary frequency, urgency, and waking at night to pass urine.
PATIENT JOURNEY

 

 

 

What does a cystectomy involve?

Cystectomy involves removing the bladder by separating it from surrounding structures, including the urethra (waterpipe), pelvic floor, and other pelvic organs.

In men, the prostate gland and seminal vesicles are usually also removed. In women, the uterus, fallopian tubes and ovaries are usually also removed.

If the operation is for aggressive bladder cancer, the lymph nodes surrounding the bladder are usually removed.

Our urologists usually perform cystectomy using the da Vinci robotic surgical system, through six to seven keyhole incisions in the abdomen, with one larger (5-10cm) incision to remove the bladder.

The procedure is performed under a general anaesthetic.

What is an ileal conduit?

After the bladder is removed, urine is drained via a urinary diversion. The most common urinary diversion is an ileal conduit.

To create an ileal conduit, a 15cm segment of small bowel is separated from the rest of the bowel to make the conduit. The remainder of the small bowel is joined back together.

One end of the conduit is joined to the ureters (tubes draining the kidneys). The other end of the conduit is brought out onto the skin of the abdomen to form a stoma.

Urine drains continuously via the stoma into a stoma bag.

What is a neo-bladder

A neobladder is an alternative to an ileal conduit urinary diversion. A neo-bladder allows you to pass urine via the urethra and does not require a stoma bag.

To create a neo-bladder, a 40-60cm segment of small bowel is separated from the rest of the small bowel.

This bowel segment is refashioned into a reservoir to store urine. The neobladder is connected to the urethra (waterpripe) and ureters (the tubes drainaing urine from the kidneys).

 

What is the recovery after cystectomy?

Cystectomy usually requires a one to two week stay in hospital.

You may not be able to eat normally for the first few days after the procedure because the bowel slows down. Once the bowel starts working normally you can slowly return to eating.

You will have a drain coming out of the abdomen and stents tubes in the ureters. They may be removed while you are in hospital or at an outpatient appointment.

If you have an ileal conduit, you will be taught how to manage the stoma bag before discharge from hospital.

It will usually take several months to completely recover from a cystectomy and to return to all normal activities.

Will any other bladder cancer treatment be required after cystectomy?

The bladder is sent for further testing after the operation. The results tell us how likely it is that the operation has cured the cancer.

Sometimes chemotherapy is required either before or after surgery.

We monitor for signs of cancer recurrence after the operation with regular scans. If there is evidence of cancer recurrence, further treatment such as chemotherapy, immunotherapy, or radiation therapy may be required.

OUR TEAM

Meet our Urologists

The following Urologists in our practice perform cystectomy:

Dr Jason Paterdis

Dr Jason Paterdis

Urologist
Dr Anojan Navaratnam

Dr Anojan Navaratnam

Urologist
Dr Andrew Keller

Dr Andrew Keller

Urologist

Meet with one of our Urologists to discuss bladder cancer treatment

Contact us to book an appointment