Radical Cystectomy Overview

A radical cystectomy is a surgery to remove the bladder.

Prior to Procedure

Doctors recommend that you quit smoking before surgery. You may also need to take antibiotics to prevent infection and laxatives to clean out the bowels.

The night before, you may be asked not to eat anything and only drink clear liquids. After midnight and on the morning of the procedure, do not eat or drink anything. This includes avoiding clear liquids, coffee, tea, and water.

Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)

Anesthesia

General anesthesia is given before surgery. You will be asleep.

Description of Procedure

An incision will be made in the abdomen to expose the bladder. All blood vessels to the bladder will be cut. The bladder will then be removed. Other tissues and organs may also need to be removed with the bladder.

The doctor will also need to create a new way for urine to be passed out of the body. A new bladder may be built using pieces of intestine, or an external bag may be attached to the abdomen.

Kidneys, Ureters, and Bladder © 2009 Nucleus Medical Media, Inc.

How Long Will It Take?

About 1-5 hours

How Much Will It Hurt?

Anesthesia will prevent pain during the surgery. Recovery is usually painful. Your doctor will give you medicine to help manage the pain.

Average Hospital Stay

The usual length of stay is 5-12 days. The specific length will depend on your condition and the reason for surgery. Your doctor may also choose to keep you longer if complications arise.

Post-procedure Care

At the Hospital

• A stay in the intensive care unit for 2-3 days may be needed.

• During surgery, a tube will be placed from the nose to the stomach. It will remain in for several days. Since you cannot eat with the tube in place, you will receive IV fluids.

• If a urine bag was attached during the surgery, you will be taught how to dispose of urine.

At Home

When you return home, do the following to help ensure a smooth recovery:

• Strenuous activity should be avoided for 4-6 weeks.
• Avoid heavy lifting, straining, and sexual activity for a period of time.
• Driving, showering, and climbing stairs is usually allowed. Ask your doctor about any restrictions.
• Be sure to follow your doctor's instructions .

RESOURCES:

National Kidney and Urologic Diseases Information Clearinghouse
http://kidney.niddk.nih.gov/

Urology Health.org
http://www.auafoundation.org/

CANADIAN RESOURCES:

Canadian Urological Association
http://www.cua.org/

Public Health Agency of Canada
http://www.phac-aspc.gc.ca/

References:

Bladder cancer. AP John Institute for Cancer Research website. Available at: http://www.apjohncancerinstitute.org/cancer/bladder.htm . Accessed February 25, 2007.

Campbell M, Wein A, Kavoussi L. Campbell-Walsh Urology. 9th ed. Philadelphia, PA: WB Saunders; 2007.

Maffezzini M, Campodonico F, Canepa G, Gerbi G, Parodi D. Current perioperative management of radical cystectomy with intestinal urinary reconstruction for muscle-invasive bladder cancer and reduction of the incidence of postoperative ileus. Surg Oncol. 2008;17(1):41-48.

Medical tests and procedures: radical cystectomy. Franciscan Medical Group website. Available at: https://www.fhshealth.org/medSurg_proced/cystectomy.asp . Accessed February 25, 2007.