Cystectomy

A cystectomy is a surgical procedure that involves the removal of all or part of the bladder, which is the organ that stores urine in the body.

Types of Cystectomy

• Partial Cystectomy: This type of surgery involves removing only the part of the bladder that contains cancer or is damaged. The remaining healthy tissue is left intact.
• Radical Cystectomy: This is a more extensive procedure where the entire bladder is removed, along with nearby tissues and organs such as the prostate gland in men, and the uterus, ovaries, and part of the vagina in women.
• Simple Cystectomy: This involves removing the bladder without taking out any surrounding tissue or organs.

Reasons for Cystectomy

A cystectomy may be performed to treat various conditions, including:

• Bladder cancer: To remove cancerous cells and prevent them from spreading to other parts of the body.
• Interstitial cystitis: A chronic condition that causes bladder pain and inflammation.
• Neurogenic bladder: A condition where the nerves that control the bladder are damaged, leading to problems with urination.
• Bladder damage or rupture: Due to injury or other medical conditions.

Surgical Approaches

A cystectomy can be performed using different surgical approaches, including:

• Open Surgery: A traditional open surgery where a single large incision is made in the abdomen to access the bladder.
• Laparoscopic Surgery: A minimally invasive procedure where several small incisions are made, and a laparoscope (a thin tube with a camera) is used to visualize the area.
• Robotic-Assisted Surgery: A type of minimally invasive surgery that uses a robotic system to assist the surgeon during the procedure.

Risks and Complications

As with any surgical procedure, there are risks and complications associated with cystectomy, including:

• Bleeding or hemorrhage
• Infection
• Damage to surrounding organs or tissues
• Urinary incontinence or retention
• Bowel obstruction or constipation
• Nerve damage or numbness

Recovery and Follow-up

After a cystectomy, patients typically require several weeks to recover. They may need to:

• Stay in the hospital for several days after surgery
• Use a catheter to drain urine from the body
• Follow a specific diet and exercise plan to aid in recovery
• Attend follow-up appointments with their doctor to monitor healing and remove any sutures or staples.

Urinary Diversion

In cases where the bladder is completely removed, patients may require a urinary diversion procedure to create a new way for urine to exit the body. This can include:

• Ileal Conduit: A section of intestine is used to create a conduit for urine to flow out of the body.
• Neobladder: A new bladder is created using a section of intestine, which allows patients to urinate normally.
• Urostomy: A bag is attached to the abdomen to collect urine, which is then emptied regularly.