Why is this procedure done?
A cystectomy is a procedure to take out the bladder. A radical cystectomy takes out the bladder and other structures that are near it. This procedure is done to treat bladder cancer. It may also be done if there are problems with the nerves that control the bladder. If the bladder has been damaged, the doctor may suggest this procedure. The doctor will need to make an opening where the urine will drain after surgery. Urine may drain into a small pouch all the time or you may have to use a thin flexible tube to remove the urine. Talk to your doctor about how urine will leave your body after this surgery. ‚
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What will the results be?
Your doctor will remove your bladder, other organs, and lymph nodes near it. This will prevent more spread of cancer cells. You will have a different way to pass your urine. ‚
What happens before the procedure?
- Your doctor will take your history. Talk to the doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your plans for having children. You may need to see a fertility specialist.
- Your doctor will do an exam and may order:
- Lab tests
- Intravenous pyelogram (IVP)
- Cystoscopy ¢ ˆ ’ To look into the bladder
- Ultrasound
- CT scan
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, the staff will put an IV in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery.
- The doctor will clean the area just below your belly button with an antiseptic. The doctor will shave the area if needed. The doctor will cut the skin and take out the bladder and other organs.
- For females, the doctor will take out the reproductive organs. Part of the vagina is also taken out.
- For males, the prostate and seminal vesicles are taken out.
- Your doctor will need to make a new way for urine to leave your body.
- Your cuts will be closed with stitches or staples and covered with a clean bandage.
- The procedure takes 1 to 5 hours.
What happens after the procedure?
- You will go to the Recovery Room and the staff will watch you closely. You may have to stay in the hospital for 5 to 10 days.
- You may have discomfort and numbness after the procedure. This may become more painful when the anesthesia wears off. Your doctor will give you drugs for pain.
- Your doctor may leave a tube in your wound. This tube will drain excess fluids that may be inside your wound. The doctor may remove the tube before you go home.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Learn how to drain the urine from your body.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work, driving, or sex
- Be sure to wash your hands before touching your wound or dressing.
- For females:
- You can wash between your legs with soap and water when your doctor tells you. This will help prevent infection.
- You can expect some bleeding from your vagina for a few weeks. You may use sanitary pads but not tampons.
- You may have problems or discomfort with sex. Ask your doctor what may help with this.
- For males:
- If your prostate is removed during the surgery, you may have trouble getting and keeping an erection. Ask your doctor what may help with this.
What follow-up care is needed?
- Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
- Your doctor will tell you if you need other drugs, like hormone therapy, if your ovaries were removed.
What lifestyle changes are needed?
- You may have to limit your activity. Talk to your doctor about the right amount of activity for you.
- You may have to use lubricating gels or vaginal moisturizers when having sex. Ask your doctor what lubrication is best for you.
What problems could happen?
- Infection
- Wound opening
- Heavy blood loss
- Blood clots in your legs or lungs
- Problems during sex
- Injury to the intestines
- Kidney problems
- Problems passing urine
When do I need to call the doctor?
- Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine.
- Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- Excessive blood in your sanitary pads, or more than 6 soaked pads per day
- Upset stomach, throwing up, or very bad belly pain
- Pain not relieved by the drugs you are taking
- No bowel movement after 3 days
- If you feel the need to pass urine but it will not come out even after 6 hours
- Sudden increase in blood in the urine
- Smelly green or dark yellow vaginal discharge
- Low mood
Where can I learn more?
American Cancer Society ‚
http://www.cancer.org/Treatment/TreatmentsandSideEffects/PhysicalSideEffects/SexualSideEffectsinWomen/SexualityfortheWoman/sexuality-for-women-with-cancer-rad-cystectomy ‚
Cancer Research UK ‚
http://cancerhelp.cancerresearchuk.org/type/bladder-cancer/treatment/invasive/surgery/types-of-surgery-for-invasive-bladder-cancer ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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