Cystectomyrelated

Cystectomy is the surgical removal of the urinary bladder. Cystectomy-related topics include indications for removal, operative approaches, urinary reconstruction after bladder removal, and the short- and long-term outcomes and complications.

Indications include muscle-invasive bladder cancer and select high-risk non-muscle-invasive tumors, as well as certain benign conditions. Radical cystectomy removes the bladder and nearby organs (in men: prostate and seminal vesicles; in women: uterus, ovaries, and part of the vagina). Partial cystectomy may be used for solitary tumors in carefully chosen patients.

Urinary diversion is required after cystectomy. The most common option is an ileal conduit. Other choices include orthotopic neobladder (a reservoir connected to the urethra) and continent reservoirs. The choice depends on tumor characteristics, kidney function, patient health, and preference.

Approaches include open, laparoscopic, and robotic-assisted cystectomy. Robotic-assisted procedures are common in experienced centers and may reduce blood loss, but results depend on surgeon skill and patient factors.

Cystectomy-related complications include infection, bleeding, and ileus. Urinary-diversion issues can involve stoma problems, conduit obstruction, leaks, and metabolic disturbances such as electrolyte imbalances and vitamin B12 deficiency. Sexual dysfunction is a concern after radical cystectomy for many patients.

Postoperative care emphasizes catheter and stoma or reservoir management, cancer surveillance, and rehabilitation. Long-term outcomes depend on cancer stage and overall health; quality of life varies with the type of urinary diversion and individual adaptation.