Cystectomy is surgery to remove all or part of the bladder. The procedure may be “partial” in which only the part of the bladder with the cancer is removed, “simple” in which the entire bladder is removed, or “radical” in which the entire bladder plus other organs in the area that also have cancer are removed. With entire removal, a new way for urine to pass outside the body is created.
At Cooper University Hospital, our urological surgeons offer world class care and have extensive experience performing cystectomy.
Understanding the Procedure
General anesthesia may be given to ensure the person remains unconscious and relaxed during the procedure. Methods used to perform the procedure include open surgery performed by creating a large incision across the lower stomach area; laparascopically performed using thin instruments placed into the area through small incisions while the surgery is viewed on a monitor by the surgeon; or robotically using specialized robotic arms inserted through small incisions while the surgeon sits at a console.
Once the bladder is accessed, the surgeon may choose to perform the operation with the bladder remaining inside the abdominal cavity (transperitoneal) or with the bladder lifted outside of the cavity (extraperitoneal). The cancerous area is cut out or the entire bladder, along with other organs if necessary, is removed. The removed tissue and organs may be examined by a pathologist to determine the presence of abnormal cells.
If the entire bladder is removed, the surgeon will create a new way for urine to be passed out of the body. A new bladder may be built using pieces of intestine (neobladder) or an external bag may be attached to the stomach.
Indications for the Procedure
Cystectomy is typically used to treat bladder cancer. Other conditions that may also require cystectomy include chronic inflammation of the bladder (interstitial cystitis), endometriosis that has spread to the bladder, severe urinary dysfunction, damage to the bladder from radiation or other treatments, or excessive bleeding from the bladder.