Facing a challenging diagnosis of bladder cancer or severe bladder dysfunction, patients at PromiseCare Medical Group in Hemet, California, may be recommended to undergo cystectomy or bladder removal surgery. This major surgery involves removing the bladder and possibly surrounding tissues and organs to alleviate symptoms and improve quality of life.
Adapting to a new way of managing urine can be intimidating, but with the proper care and support from the medical team, patients can navigate this challenging time. As patients consider this life-changing surgery, they likely wonder what to expect, what risks are involved, and how to prepare.
The medical team at PromiseCare Medical Group provides guidance and support throughout this journey, from pre-surgery preparation to post-surgery care and recovery.
Overview
A cystectomy is a surgical procedure that removes part or all of the urinary bladder, typically performed to treat bladder cancer or severe bladder dysfunction.
There are two main types of cystectomy: radical cystectomy, which removes the entire bladder and surrounding organs, and partial cystectomy, which removes only a portion of the bladder.
After surgery, urinary diversion is necessary to manage urine flow; this may involve an ileal conduit, continent urinary diversion, or neobladder reconstruction.
The hospital stay for cystectomy typically ranges from 5 to 12 days, and recovery can take several weeks to months.
It is essential to focus on overall well-being during this challenging time. A cystectomy is a significant step towards treating the underlying condition and improving quality of life.
It’s possible to adjust to the new normal with time. The medical team will support the process from preparation to recovery.
Types
Understanding the different types of cystectomy procedures can help alleviate uncertainty and empower informed decision-making for individuals navigating bladder removal surgery. The kind of cystectomy needed depends on several factors, including the stage of bladder cancer, overall health, and the extent of disease spread.
There are several types of cystectomy to be familiar with:
- Radical cystectomy: involves the removal of the entire bladder, surrounding lymph nodes, and potentially reproductive organs.
- Partial cystectomy: a less standard procedure that removes only the tumor and a small portion of the bladder, preserving the majority of the organ.
- Simple cystectomy: performed for non-cancerous conditions, where the bladder is removed without affecting surrounding structures.
The most effective approach for surgery is also considered, including open cystectomy with a single large incision or minimally invasive techniques like laparoscopic or robotic-assisted surgery, which use smaller incisions for reduced recovery times and pain.
Understanding these options helps individuals discuss the best course of treatment and receive the most suitable care for their condition.
Why it’s done
Facing a diagnosis that requires bladder removal surgery can be a challenging experience, and understanding the reasons behind this life-changing decision is essential. A cystectomy may be necessary to remove the bladder and potentially save a person’s life if they’ve been diagnosed with bladder cancer that has grown into the muscle layer of the bladder or if carcinoma in situ persists after other treatments.
Other reasons for a cystectomy include severe bladder dysfunction due to nerve damage or muscle control issues, making it difficult for the bladder to store or expel urine properly. A traumatic injury to the bladder or uncontrolled bleeding may also necessitate the removal of the bladder to alleviate life-threatening conditions.
In some cases, chronic inflammation or debilitating conditions like interstitial cystitis may lead to a cystectomy when other treatments fail. Additionally, if a person has recurrent non-muscle invasive bladder cancer with a high risk of progression, removing the bladder may significantly reduce the risk of cancer recurrence.
Understanding why a cystectomy is recommended can help prepare for this significant step in a person’s healthcare journey.
Who it’s for
Cystectomy, or bladder removal surgery, is typically recommended for patients diagnosed with muscle-invasive bladder cancer, where the cancer has spread into or through the bladder muscle layer.
It may also be considered for those with high-risk non-muscle invasive bladder cancer that recurs after initial treatment.
Patients experiencing severe bladder dysfunction due to various conditions may also be candidates for cystectomy, including:
- Neurogenic conditions that affect bladder control
- Significant bladder damage from radiation or chemotherapy
- Debilitating symptoms from non-cancerous conditions, such as recurrent infections or bladder pain syndrome
A thorough oncological assessment and multidisciplinary consultation are essential to determine whether cystectomy is the best course of action.
The decision to undergo surgery is based on factors such as overall health, cancer stage, and potential benefits, including improved quality of life and reduced risk of future complications.
If cystectomy is recommended, the specifics of the surgery, including urinary diversion options and follow-up care, will be discussed.
Risks
Undergoing bladder removal surgery can be intimidating, carrying with it a multitude of risks that require careful consideration. As one prepares for this life-changing procedure, it’s vital to understand the potential complications that may arise. A significant percentage of patients experience major complications, including postoperative infections, bleeding, and issues related to urinary diversion methods.
Long-term changes in urinary function (such as incontinence or difficulty voiding) can also occur, notably impacting daily life. Beyond physical risks, the emotional and psychological impact of bladder removal surgery shouldn’t be underestimated. Anxiety and depression can arise post-surgery, emphasizing the need for a robust support system and psychological support.
Additionally, during surgery, there’s a risk of damage to nearby organs, such as the intestines or reproductive structures. It’s essential to be aware of signs of complications, such as persistent fever, increasing abdominal pain, or changes in urinary output, and seek medical attention promptly if these symptoms occur.
How you prepare
Preparation is crucial in the days leading up to bladder removal surgery. Proactive steps can minimize surgical risks and ensure a smooth recovery. A thorough consultation with a healthcare provider is necessary to discuss current medications, as certain medications and surgery need to be stopped or adjusted to reduce the risk of complications.
Antibiotics may be prescribed to prevent postoperative infections. Bowel preparation is also essential to secure a clean surgical field during the procedure, which may involve using laxatives or other medications to cleanse the bowel.
Key preparation steps include:
- Stopping smoking to enhance healing and reduce surgical risks
- Following bowel preparation instructions carefully to guarantee a clean surgical field
- Fasting from midnight the night before surgery, allowing only small sips of water for necessary medications.
What you can expect
During the hours leading up to bladder removal surgery, anticipation can be overwhelming. Preparing for cystectomy typically involves a mix of emotions, including anxiety, uncertainty, and hope for a successful outcome.
The surgery usually lasts between 3 to 6 hours and is performed under general anesthesia, ensuring the patient remains pain-free and unconscious throughout.
After surgery, patients spend several days in the hospital, typically between 5 to 12 days, with close monitoring in an intensive care unit or high-dependency unit.
Recovery involves learning to manage a new urinary diversion method, which may include using an external bag or internal pouch for urine collection. A nasogastric tube may be used for gastric decompression, and intravenous fluids may be administered, as eating can be challenging initially.
Recovery requires preparation for potential long-term lifestyle adjustments, including changes in urinary function and the need for ongoing follow-up care.
A healthcare team provides education and support to help patients adapt to their new situation and ensure a smooth transition back to daily life.
Results
Surgery is complete, and the initial steps of recovery are underway. As patients navigate the post-cystectomy landscape, they encounter significant changes in urinary function. Adapting to a new urinary diversion method, such as an ileal conduit or neobladder, can be challenging.
However, learning to manage the new system is possible with proper guidance and support.
Key aspects to consider moving forward include:
Lifestyle adjustments are required: Diet changes and new routines may be necessary to manage urinary output and guarantee ideal recovery and quality of life.
Emotional support is vital: A significant percentage of patients experience anxiety or depression after cystectomy. Counseling or support groups can help cope with the psychological impacts of bladder removal.
Follow-up care is essential: Regular monitoring helps prevent complications related to urinary diversion and detect potential cancer recurrence.
