Radical Cystectomy

About Radical Cystectomy

Radical cystectomy is the removal of the entire urinary bladder, most often for muscle invasive bladder cancer or high risk non muscle invasive cancer that has not responded to other treatment. In men the operation usually includes removal of the prostate and seminal vesicles, and in women it traditionally includes the uterus, ovaries and part of the vaginal wall, although organ sparing variations exist. Pelvic lymph nodes are removed at the same time. Because the bladder is gone, a new way for urine to leave the body must be created, a step called urinary diversion. Options include an ileal conduit, in which a short segment of small intestine carries urine to an opening on the abdomen, a continent cutaneous reservoir, and an orthotopic neobladder, a pouch made from intestine connected to the urethra. The operation can be performed open or with robotic assistance. It is often preceded by chemotherapy. Radical cystectomy is one of the most extensive operations in urology and is generally performed at specialized centers.