A Simple Guide to Bladder Removal Surgery

A Short Introduction About Bladder Cancer

Bladder cancer happens when abnormal cells grow in the bladder (the organ that stores urine). If not treated, these cells can spread to nearby tissues or other parts of the body. It happens because of changes in the DNA of the cells of your urinary bladder.

Who is at Risk?

• People who smoke
• Those above the age of 55 years
• Males
• Those who have been exposed to certain harmful chemicals
• People who have been treated for cancer before
• Family history of cancer
• Repeated bladder or urinary infections

Symptoms

• Blood in urine which may cause urine to appear bright red/cola-coloured; can sometimes appear normal and is detected through a lab test
• Frequent urination
• Painful urination
• Back pain

Diagnosis

• The doctor inserts a small tube with a camera to look into your bladder (cystoscopy)
• Your doctor takes a small sample tissue from the area (biopsy)
• Urine tests
• Imaging tests like computed tomography (CT) or magnetic resonance imaging (MRI)

Treatment

• Radiation therapy
• Medicines to help your body fight the cancer
• Medicines that target the cancer cells (chemotherapy)
• Surgical removal of the affected bladder (cystectomy) or the cancer cells

Cystectomy

What is a Cystectomy?

Cystectomy is a type of surgery where a part of or all of your bladder is removed.

Who Needs it and Why is it Done?

• Usually performed for people with bladder cancer, especially when the cancer has spread
• People with urinary issues from birth
• Those who have suffered from some issue due to other types of cancers

Open vs Laparoscopic vs Robotic Surgery

Benefits of Robotic Surgery

• Smaller surgical cut
• Blood loss is low during surgery
• Shorter length of hospital stay
• Lower risk of surgery-related issues
• Faster return to normal diet
• Better removal of tumour

What Happens Before the Surgery?

Before the surgery, your doctor will:

• Review your medical records and give you a checkup to see if you are fit enough for the surgery
• Discuss any medicines which you might be taking
• Ask about any allergies you might have
• Instruct you on when to stop the medicines (if any) and when to have your last meal

What Happens During the Surgery?

• The patient is given sleep or pain-blocking medicine for comfort during the procedure
• Small cuts are made in your abdomen through which a tube with a camera is inserted
• The surgeon removes the affected portion or the entire bladder (as required) with the help of a robotic system
• They then rebuild the bladder using small parts of your small intestine or large intestine
• This surgery takes around 6 hours

Risks & Complications

Common Risks

• Wound healing issues
• Pain
• Bleeding
• Infection
• Bowel issues

Rare but Major Health Risks

• Organ damage
• Scarring (marks on the skin after a wound heals)
• Reaction to anaesthesia
• Blood clot

After the Surgery

• Your health will be monitored
• Doctors will treat your pain
• Your appetite will be smaller
• You might have some problems going to the washroom
• Some sexual side effects might also be seen

Recovery Time

• Most patients are discharged after 3–5 days
• You will be able to return to work a few weeks after the surgery
• Do not exert yourself physically for at least 6 weeks

Benefits and Success Rate

Benefits of the Procedure

Treats bladder cancer and other bladder-related conditions.

Success Rate

The surgery has good success rate for treating cancer.

Taking Care After the Surgery

• You might find yourself getting tired easily. This is normal and can happen for up to 6 months
• Any tubes which are attached will slowly be removed after a few weeks
• Follow-up appointments are done after 2–3 weeks
• The functioning of your bowels is checked after the surgery

Diet and Lifestyle

• Drink plenty of fluids (2–3 litres)
• Have frequent smaller meals through the day
• Eat foods high in fibres to prevent constipation
• Gentle exercises like walking are encouraged
• Return to work after 6 weeks usually

Activity Restrictions

• Avoid driving if you have any pain or are on painkillers
• Avoid any long/overseas travel for at least 6 weeks
• Avoid any heavy lifting

Medicines

• You can resume your usual medicines
• If you are on blood-thinning medication, your doctor will let you know when to resume
• You can take 1–2 Paracetamol every 4–6 hours for pain and discomfort (no more than 8 in a day)
• Stronger pain medications should be taken only as prescribed by the doctor; do not take them for too many days, as they can cause side effects

Myth Busters

Frequently Asked Questions