Cystectomy (bladder removal surgery)

Cystectomy is a surgical procedure to remove all or part of the bladder. Cystectomy is most often used to treat bladder cancer.

Cystectomy may be used to treat:

• Cancer that begins in the bladder or that begins nearby and grows to involve the bladder
• Birth defects that affect the urinary system
• Traumatic injuries to the bladder
• Neurological disorders that affect the urinary system

Cystectomy is a complex procedure and surgeons may use different techniques to perform it, such as:

• Open surgery, which requires one long incision to access the bladder
• Minimally invasive surgery, which involves several small incisions where special surgical tools are inserted to access the bladder
• Robotic surgery, which is a type of minimally invasive procedure in which the surgeon sits at a console and remotely operates the surgical tools

If your bladder is removed completely, surgeons work to reconstruct the urinary tract in order to allow urine to leave your body. Several options exist:

• Urinary conduit (ileal conduit or urostomy). During this procedure, the surgeon uses a piece of your intestine to create a tube that runs from your kidneys to your abdominal wall. A bag you wear on your abdomen collects the urine.
• Cutaneous continent urinary diversion (Indiana pouch).During this procedure the surgeon uses a piece of your intestine to create a tube that runs from your kidneys to a small reservoir that’s attached to the inside of your abdominal wall. You use a catheter to empty the reservoir through your bellybutton several times a day.
• Orthotopic continent urinary diversion (neobladder).During this procedure the surgeon uses a piece of your intestine to create a tube that runs from your kidneys to a small reservoir that allows you to urinate through your urethra in a relatively normal fashion.

What type of cystectomy and reconstruction you undergo depends on several factors, such as the reason for your surgery, your overall health and your preferences. Discuss your options with your surgeon to determine which procedures are right for you.

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