Radical Cystectomy

Radical cystectomy is a major surgical procedure used to remove the entire bladder, surrounding tissues, and, in some cases, nearby lymph nodes. It's often performed to treat invasive bladder cancer that has not responded to other treatments or has a high risk of recurrence.

Purpose:

Treatment of Bladder Cancer: Radical cystectomy is the primary treatment for aggressive or advanced bladder cancer that has invaded the muscle wall of the bladder or is recurrent despite other treatments.

Procedure Steps:

Anesthesia: The patient receives general anesthesia to ensure unconsciousness and pain control throughout the surgery.
Incision: An incision is made in the abdomen to access the bladder and surrounding tissues.
Bladder Removal: The surgeon carefully removes the entire bladder, along with nearby lymph nodes and surrounding tissues. In men, removal of the prostate and seminal vesicles might also be necessary. In women, the uterus, ovaries, fallopian tubes, and part of the vagina might be removed as well.
Urinary Diversion: After the bladder is removed, the surgeon creates a new way for urine to leave the body. This can be done through various methods like creating an ileal conduit (using a piece of the small intestine to redirect urine to a stoma on the abdomen) or a neobladder (constructing a new bladder-like pouch from intestines to store and void urine).
Closure: Once the necessary structures are removed or rearranged, the surgeon closes the incision using sutures or staples.

Aftercare:

Hospital Stay: Patients typically stay in the hospital for about a week after the surgery, depending on their recovery progress.
Recovery Period: Recovery can take several weeks to months, and patients will need to gradually resume normal activities.
Adjustment to Urinary Diversion: Patients will need to learn how to manage their new urinary system and follow specific care instructions.

Risks and Considerations:

Bleeding: There's a risk of bleeding during or after the surgery, which is managed by the surgical team.
Infection: Infections are possible but are usually treated with antibiotics.

Urinary Changes: Adjusting to the new urinary system might involve changes in urination patterns and require ongoing management.

Recovery and Follow-up:

Adapting to the Changes: Learning to manage the new urinary system and lifestyle adjustments are crucial.
Regular Follow-ups: Patients will require regular check-ups to monitor recovery and ensure there are no signs of cancer recurrence.

Radical cystectomy is a significant surgery used in the treatment of invasive bladder cancer. It involves the removal of the bladder and surrounding structures and requires adjustment to new urinary diversion methods. The decision to undergo this procedure involves a thorough discussion between the patient and healthcare team, considering various factors including the extent of the cancer and the patient's overall health.