Surgery called cystectomy may be needed if you have cancer that could or has entered the bladder muscle. In this case, all or part of the bladder may be removed. If you have CIS, or high grade Ta or T1 cancer that has not improved or has returned after treatment, your doctor may recommend this surgery. If your cancer has a high risk of spreading into the muscle, you may want to consider cystectomy as a first choice.
Male and Female Bladder and Urethra
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Partial Cystectomy (removal of part of the bladder)
For some people with a single, small tumor in the bladder, the surgeon does not remove the entire bladder. The surgeon removes the tumor, the part of the bladder containing the tumor, and nearby lymph nodes. After part of the bladder is removed, you may not be able to hold as much urine in your bladder as before surgery. You may need to empty your bladder more often. This problem usually gets better with time. 1
Radical Cystectomy (removal of the whole bladder)
For bladder cancer that has invaded the muscle layer (Stage 2 or some Stage 3), the most common type of surgery is radical cystectomy. The surgeon removes the entire bladder, nearby lymph nodes, and part of the urethra. In addition, the surgeon usually removes the prostate from a man and may remove the uterus from a woman. Other nearby tissues may also be removed. 2
When the entire bladder is removed, the surgeon makes another way for urine to be collected from the kidneys and stored. You may wear a flat bag outside the body under your clothes, or the surgeon may use part of your intestine to create a pouch inside the body. 3
Ask your doctor about the risks of cystectomy and the methods of urinary reconstruction. Also called urinary diversion, this surgery creates a new way to store and remove urine after your bladder is removed.
When the prostate or uterus is removed, a man can no longer father a child and a woman can no longer get pregnant. Also, a man may be unable to have sex after surgery. If the surgeon removes part of a woman's vagina, sex may be difficult. 4
Because bladder cancer surgery may affect your sex life, it may help you and your partner to talk about your feelings and help one another find ways to share intimacy during and after treatment. 5
If you have a partner, you may be worried about maintaining sexual intimacy and your relationship. If you do not have a partner, you may want help talking through how to manage your dating life after bladder cancer surgery. Either way, you (and your partner) may benefit from the advice of a counselor who specializes in discussing sexual issues. Your urologist may be able to refer you to medical professionals and counselors who specialize in sexual issues after cancer treatment. You can also find a certified sex therapist near you on the website of the American Association of Sexuality Educators, Counselors and Therapists.
It takes time to heal after surgery, and the time needed to recover is different for each person. It's common to feel weak or tired for a while. 6
Also, you may have pain or discomfort for the first few days. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain control. 7