Search - Cystectomy

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Description

Cystectomy is a surgical procedure that facilitates the complete or partial removal of the bladder. Generally, the procedure is performed for treating bladder cancer. Cystectomy can be performed as: Partial Cystectomy, wherein only a part of the bladder is removed. It is performed when the cancer is only in one region of the bladder, and is not in the area where urine enters or leaves the bladder.Radical Cystectomy, wherein enter bladder is removed along with nearby parts. In men, prostate gland, seminal vesicles and portion of vas defernes are also removed. While in women, cervix, uterus, ovaries, fallopian tubes and part of vagina are also removed. After the surgery, the urinary tract will be reconstructed. Partial Cystectomy, wherein only a part of the bladder is removed. It is performed when the cancer is only in one region of the bladder, and is not in the area where urine enters or leaves the bladder. Partial Cystectomy Radical Cystectomy, wherein enter bladder is removed along with nearby parts. In men, prostate gland, seminal vesicles and portion of vas defernes are also removed. While in women, cervix, uterus, ovaries, fallopian tubes and part of vagina are also removed. After the surgery, the urinary tract will be reconstructed. Radical Cystectomy

Symptoms

The doctor will recommend the surgery to treat: Bladder Cancer that has spread into bladder wall or has recurred after initial medical treatmentCongenital defects that affect urinary systemSevere injuries to the bladder Bladder Cancer that has spread into bladder wall or has recurred after initial medical treatment Congenital defects that affect urinary system Severe injuries to the bladder

Pre Procedure

The doctor will recommend the following: CT Scan, biopsy of bladder, urine analysis, cystoscopy and other tests to determine the exact location and spread of the cancerStop blood thinning medications, at least 10 days before the surgeryFasting for 8 to 10 hours prior to the procedure CT Scan, biopsy of bladder, urine analysis, cystoscopy and other tests to determine the exact location and spread of the cancer Stop blood thinning medications, at least 10 days before the surgery Fasting for 8 to 10 hours prior to the procedure

During Procedure

The procedure is performed under general anesthesia, and can take upto 3 to 4 hours. For open surgery, the surgeon will make a long incision in the lower abdomen area to access the bladder and lymph nodes. For laparoscopic surgery, several small incisions are made in the lower belly. A laparoscope containing camera is inserted from one of the cuts, and surgical tools are inserted from other incisions. In partial cystectomy, the affected part of the bladder is removed and the incisions are sutured. In case of Radical Cystectomy, the surgeon has to create a passage for the urine to pass out of the body. This can be done using Urinary Conduit: A part of small intestine is used to make an ileal conduit or a tube. Ureters that drain urine from kidney are attached to the abdominal wall using this tube. In the abdomen, an opening in the skin allows the patient to drain the urine. Continent Urinary Diversion: In this method, a small reservoir is created in the abdominal wall. The ileal conduit drain urine in this reservoid. Using a catheter, the urine is drained periodically.Neobladder: This technique is used only when the urethra is not removed. In this method, a part of the bowel is folded to make a pouch that carries the urine. This is attached to the ureters from the kidney. This procedure allows the patient to urinate in a normal way. Urinary Conduit: A part of small intestine is used to make an ileal conduit or a tube. Ureters that drain urine from kidney are attached to the abdominal wall using this tube. In the abdomen, an opening in the skin allows the patient to drain the urine. Urinary Conduit: Continent Urinary Diversion: In this method, a small reservoir is created in the abdominal wall. The ileal conduit drain urine in this reservoid. Using a catheter, the urine is drained periodically. Continent Urinary Diversion: Neobladder: This technique is used only when the urethra is not removed. In this method, a part of the bowel is folded to make a pouch that carries the urine. This is attached to the ureters from the kidney. This procedure allows the patient to urinate in a normal way. Neobladder:

Post Procedure

The patient has to stay in hospital for 7 to 10 days after the surgery. In some cases, chemotherapy or radiation therapy is prescribed. Generally, there is some discomfort and pain in the abdomen. Medications will be prescribed to minimize it. Complete recovery generally takes 6 to 8 weeks. The doctor will recommend to Avoid any strenuous activity for 6 to 8 weeks. Tests to check recurrance of cancer.Bladder exams after every 3 to 4 months.Strictly stop smoking Avoid any strenuous activity for 6 to 8 weeks. Tests to check recurrance of cancer. Bladder exams after every 3 to 4 months. Strictly stop smoking

Risk And Complications

Radical Cystectomy is a complex procedure, and complications may include: Kidney infectionLeakage in urine or obstruction in the bowelImbalance in electrolytes causing AcidosisIn long term, renal failure Kidney infection Leakage in urine or obstruction in the bowel Imbalance in electrolytes causing Acidosis In long term, renal failure Radical cystectomy may affect the fertility in men and women.

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