Medical uses and Malignancy
- Cystectomy is the surgical removal of all or part of the urinary bladder.
- The most common condition warranting cystectomy is bladder cancer.
- Cystectomy is recommended for bladder cancer that has invaded the muscle of the bladder.
- Cystectomy may be recommended for individuals with a high risk of cancer progression or failure of other treatments.
- Radical cystectomy is the recommended treatment for bladder cancer that has invaded the muscle of the bladder.
- Radical cystectomy involves removal of the entire bladder, surrounding lymph nodes, and nearby organs containing cancer.
- Pathological cancer staging is determined through evaluation of the tissue removed during cystectomy.
- Cancer staging helps determine further work-up, treatment, follow-up, and potential prognosis.

Types
- Factors considered when determining the type of cystectomy include age, overall health, bladder function, type, location, and stage of cancer.
- Partial cystectomy involves removal of a portion of the bladder and is performed for benign and localised malignant tumors.
- Candidates for partial cystectomy include those with single tumors near the top of the bladder, non-muscle invasive tumors, tumors within bladder diverticulum, or cancer not carcinoma in situ (CIS).
- Radical cystectomy is most commonly performed for cancer invading into the muscle of the bladder.
- Radical cystectomy involves removal of the entire bladder, surrounding lymph nodes, and other organs containing cancer.

Technique
- Open radical cystectomy involves a large incision in the abdomen, removal of the bladder, and potential removal of the prostate or other organs.
- Pelvic lymph node dissection is performed during open radical cystectomy.
- Minimally invasive radical cystectomy, such as robot-assisted laparoscopic cystectomy, involves small incisions and the use of surgical robots.
- Minimally invasive cystectomy may require fewer blood transfusions and shorten hospital stay compared to open surgery.
- There may be little to no difference in major complications, quality of life, recurrence, and cancerous cells left behind between robotic and open surgery.

Risks and complications
- Radical cystectomy with urinary diversion carries risks of anesthesia, bleeding, blood clots, heart attack, stroke, pneumonia, and infection.
- Infection can occur at the surgical incision sites, urinary tract, abdomen, and gastrointestinal tract.
- Complications following cystectomy include ileus (slow movement within intestines), intestinal obstruction, and leakage at reconnection sites.
- Urinary tract complications can include ureter obstruction, requiring additional procedures for drainage.
- Partial cystectomy carries risks of ureter damage and urine leakage.

Recovery
- Diet before and after surgery:
- No food or drink immediately after surgery
- Diet gradually advances to liquids and then solid foods
- Complications may slow down diet progression
- Additional nutrition may be beneficial for those with eating difficulties
- Immuno-enhancing nutrition may decrease complications
- Pain control:
- Intravenous pain medication used immediately after surgery
- Switch to oral pain medication once diet is tolerated
- Activity:
- Early activity encouraged after surgery
- Walking and sitting in a chair may be possible on the same day
- Walking around the room or hospital ward within a day or two
- Some individuals may require assistance or physical therapy
- Venous thromboembolism prevention:
- Compression devices or medications used before and after surgery
- Heparin or low molecular weight heparin commonly used
- VTE prophylaxis may continue after hospital discharge if needed
- Surgery follow-up:
- Staples removed 5 to 10 days after open cystectomy
- Follow-up with surgeon scheduled 4 to 6 weeks after surgery
- Laboratory or imaging studies may be done for assessment
- Further care and follow-up determined during the visit

Cystectomy (Wikipedia)

Cystectomy is a medical term for surgical removal of all or part of the urinary bladder. It may also be rarely used to refer to the removal of a cyst. The most common condition warranting removal of the urinary bladder is bladder cancer.

Cystectomy
Bladder layers and anatomy
ICD-9-CM	57.6-57.7
MeSH	D015653
OPS-301 code	5-576
[edit on Wikidata]

Two main types of cystectomies can be performed. A partial cystectomy (also known as a segmental cystectomy) involves removal of only a portion of the bladder. A radical cystectomy involves removal of the entire bladder along with surrounding lymph nodes and other nearby organs that contain cancer.

Evaluation of the tissue removed during cystectomy and lymph node dissection aids in determining pathological cancer staging. This type of cancer staging can be used to determine further work-up, treatment, and follow-up needed along with potential prognosis.

After the bladder has been removed, a urinary diversion is necessary to allow elimination of urine.