Radical Cystectomy is a surgical procedure to remove the bladder, a part of lymph nodes and, in some cases, nearby organs to treat bladder cancer.
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.
The surgeon will recommed radical cystectomy to treat bladder cancer. Symptoms of bladder cancer include:
Blood in the urine
Inability to control urine
Pain in the abdomen
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 cancer
Stop blood thinning medications, at least 10 days before the surgery
Fasting for 8 to 10 hours prior to the 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.
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.
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
Risk and Complications
Radical Cystectomy is a complex procedure, and complications may include:
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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