Cystectomy

A cystectomy is a surgical procedure to remove all or part of the bladder. The bladder is a hollow, muscular organ located in the pelvis. Its primary function is to store urine produced by the kidneys until it’s ready to be excreted from the body. This surgery is often performed to treat bladder cancer. Bladder removal is a major surgery and is typically recommended when other treatments, such as chemotherapy or radiation, haven’t controlled the cancer.

At Penn Medicine, our surgeons perform more cystectomies than any other hospital in the southeastern Pennsylvania and New Jersey regions. This extensive experience allows us to provide first-class care, leading to better outcomes and fewer complications for our patients.

Our surgeons perform both open and laparoscopic (minimally invasive) cystectomies. Your doctor will discuss the best choice for you.

• In an open cystectomy, doctors remove your bladder through one long incision in your lower abdomen.
• In laparoscopic procedures, doctors use special instruments and make tiny incisions to access your bladder. Sometimes, they use a surgical robot for even more precision. These techniques usually cause less pain and help you recover faster compared with open surgery.

Chemotherapy given before or after the cystectomy may also be a part of your treatment plan.

Bladder removal surgery is typically considered for patients with certain medical conditions. Your doctor may recommend a cystectomy if:

• You have bladder cancer that has spread, is at risk of spreading, or has returned after other treatments
• You experience chronic bladder pain and frequent urination that doesn’t respond to other treatments
• You were born with severe structural problems of the bladder that haven’t responded to other treatments
• You experienced a severe bladder injury that can’t be repaired
• You have a neurological condition that prevents proper bladder function, leading to severe incontinence or infections

Depending on certain factors, you may be an eligible candidate for robotic cystectomy surgery, which uses minimally invasive and robot-assisted technology to complete the bladder removal. Your care provider can discuss the option that is the best fit for you.

Before your bladder removal surgery, your doctor will thoroughly explain the procedure and address your questions. Your care team will also provide detailed instructions on how to prepare for the surgery.

During the procedure, you can expect:

• You’ll receive general anesthesia to ensure you’re asleep and pain-free during the surgery.
• If you’re having open surgery, your surgeon will make one long incision about 18 centimeters long in your abdomen and remove part or all of your bladder.
• If you’re having laparoscopic surgery, your surgeon will make several small incisions about 1 centimeter long in your abdomen and remove part or all of your bladder.
• If you’re having a radical cystectomy, typically done through open surgery, your surgeon may need to remove nearby organs affected by cancer. They’ll also create a new way for urine to exit your body.
• The surgery takes about six hours.

After laparoscopic surgery, most patients stay in the hospital for a couple of days for monitoring and initial recovery. Those who undergo open surgery will have a longer hospital stay. Before you go home, your Penn Medicine care team will provide detailed home care instructions and schedule follow-up appointments to monitor your recovery. If you have a urinary diversion, you’ll receive specific instructions on how to care for it and manage your urinary function.

At Penn Medicine, we provide exceptional care for patients with bladder dysfunctions, offering a range of specialized treatments and expertise. Several things set us apart from other hospitals in the greater Philadelphia, Lancaster, and Princeton regions:

• Comprehensive cancer care: Our surgeons work closely with urologists, oncologists, and care nurses to provide complete bladder care. This collaboration ensures you receive an inclusive treatment plan covering all your needs.
• Robotic surgery expertise: Our urologists were among the first to adopt robotic surgery for bladder treatment, starting in 2008. With an experienced surgeon and a well-established robotic program, you have a lower risk of complications and a higher chance of successful results.
• Continent urinary diversion options: For those who prefer not to wear an external urine collection pouch, we offer continent urinary diversion. Our skilled surgeons specialize in neobladder reconstruction, the most advanced option. This procedure creates a new bladder, allowing you to urinate more normally.

We’re committed to providing the highest level of care and support for our patients, helping you achieve the best possible outcomes.