Surgery: cystectomy

Most people with muscle-invasive disease or for cancer that has invaded the lamina propria and has not responded to BCG have surgery to remove the bladder (cystectomy).

Learn more about:

Types of cystectomy

Removing the whole bladder (radical cystectomy)

This is the most common operation for muscle-invasive bladder cancer. The whole bladder and nearby lymph nodes are removed. In men, the prostate, urethra and seminal vesicles may also be removed. In women, the urethra, uterus, ovaries, fallopian tubes and a part of the vagina are often removed.

Removing part of the bladder (partial cystectomy)

This type of operation is not suitable for most types of bladder cancer, so it is less common. A partial cystectomy removes only the bladder tumour and a border of healthy tissue around it.

What to expect after surgery

After a radical cystectomy, you will probably stay in hospital for 1–2 weeks. You will have tubes in your body to give you fluids and to drain the operation area. It’s common to have pain after the surgery and you may need pain relief for a few days.

How the surgery is done

Different surgical methods may be used for muscle-invasive bladder cancer.

Open surgery makes one long cut (incision). Keyhole surgery, also known as minimally invasive or laparoscopic surgery, uses several smaller cuts, sometimes with help from a robotic system.

Recovery is often faster and the hospital stay is shorter with keyhole surgery, but open surgery is recommended in some situations.

Talk to your surgeon about the pros and cons of each option. If robotic-assisted surgery is suggested, check what fees are involved. Unless you are treated as a public patient in a hospital or treatment centre that offers this at no extra cost, robotic surgery can be an expensive operation.

Side effects of cystectomy

Effects on urination

If you have a partial cystectomy, your bladder will be smaller and hold less urine, so you may need to pass urine more often. If you have a radical cystectomy, you will need to collect and store urine in another way. This is called urinary diversion – for more information, see Living with a bladder reconstruction.

Effects on sexuality

In men, the nerves needed for an erection are likely to be affected. Women who have their reproductive organs removed will go through menopause if they have not already. These changes may affect your fertility and how you feel about your sex life – for more information, see Sexuality, intimacy and fertility.

Surgery for urothelial carcinoma of the kidney or ureter

Urothelial carcinoma is the most common form of bladder cancer, but occasionally it can occur in part of the kidney (renal pelvis), a ureter or urethra.

Much of this content will be relevant if you have been diagnosed with urothelial cancer of the kidney or ureter. Symptoms include blood in the urine and back pain. Many of the same tests will be used for diagnosis, but instead of a cystoscopy, you will have a ureteroscopy, which uses a thin instrument with a light to examine the ureter and kidney.

The most common treatment is surgery to remove the kidney, ureter and part of the bladder (nephroureterectomy). Sometimes, only part of the kidney or ureter needs to be removed and in some cases a laser can be used to remove the tumour endoscopically. You may have chemotherapy or immunotherapy after surgery.

Video: What is surgery?

Watch this short video to learn more about surgery.

This information was last reviewed in February 2018
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