Cystectomy
Cystectomy is a surgical procedure to remove part or all of the bladder, primarily used for treating bladder cancer. It can be partial, targeting only the cancerous area, or radical, removing the entire bladder along with nearby lymph nodes and organs if required. Following cystectomy, patients may undergo urinary diversion surgery to establish an alternative route for urine elimination.
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Cystectomy is a surgical procedure to remove part or all of the bladder, primarily used for treating bladder cancer. It can be partial, targeting only the cancerous area, or radical, removing the entire bladder along with nearby lymph nodes and organs if required. Following cystectomy, patients may undergo urinary diversion surgery to establish an alternative route for urine elimination.
Symptoms Of Cystectomy
Symptoms
Blood in urine 
Frequent urge to urinate
Burning sensation during urination
Lower abdominal or pelvic painTypes of conditions
There are 3 main types of Cystectomy
Partial Cystectomy
Radical Cystectomy
Robot-assisted Cystectomy
Partial Cystectomy
- Removes only the cancerous part of the bladder while preserving the rest.
- Suitable for patients with early-stage bladder cancer that hasn't spread extensively.
SYMPTOMS OF CYSTECTOMY
Blood in urine - Presence of blood in the urine, known as hematuria, can indicate various underlying conditions such as urinary tract infections, kidney stones, or bladder cancer.
Frequent urge to urinate - Feeling the need to urinate frequently, even when the bladder is not full, may be a sign of conditions like urinary tract infections, overactive bladder, or interstitial cystitis.
Burning sensation during urination - Experiencing a burning or painful sensation while urinating is often a symptom of urinary tract infections, sexually transmitted infections, or irritation of the urethra.
Lower abdominal or pelvic pain - Pain in the lower abdomen or pelvic region can result from conditions such as urinary tract infections, bladder infections, kidney stones, or menstrual cramps.
DIAGNOSIS
Cystoscopy with Biopsy - A procedure where a small tube (cystoscope) is inserted through the urethra to examine the bladder's interior for abnormalities.A biopsy is then taken in the same procedure to assess the grade of cancer. This can be therapeutic for smaller cancers.
Urine cytology- Examination of urine under a microscope to detect cancer cells.
Imaging Tests- CT urogram, retrograde pyelogram, CT scan, MRI, PET scan, bone scan, and chest X-ray are used to visualize the urinary tract and assess cancer spread to lymph nodes or other areas of the body.
TREATMENTS
Treatment options for bladder cancer include:
-
Partial cystectomy- Removal of only a portion of the bladder.
-
Radiotherapy- Using high-energy radiation to destroy cancer cells.
-
Chemotherapy- Medications to kill cancer cells or prevent their growth.
-
Combination therapy- A mix of radiotherapy and chemotherapy for enhanced effectiveness.
-
Bladder preservation techniques to avoid complete removal of the bladder.
Treatment usually entails a combination of these treatments. Your doctor will discuss with you and provide options based on your diagnosis.
RISK FACTORS
Factors that can heighten the risk of bladder cancer include:
- Smoking
- Advancing age > 55 years
- Men are at a higher risk
- Certain chemicals found in dyes, rubber, textiles, and paints, as well as arsenic, can increase the risk of bladder cancer
- Cyclophosphamide and pelvic radiation therapy for other cancers can increase bladder cancer risk
- Chronic bladder inflammation by long-term catheter use or the parasitic infection
- Personal or family cancer history
PREPARIG FOR SURGERY
- Thorough discussions with surgeon, anesthesiologist, and healthcare team to assess health status and surgery impact.
- Factors considered: medical history, drug allergies, previous anesthesia reactions, conditions like obstructive sleep apnea.
- Disclose medication, supplement, alcohol, tobacco, recreational drug, and caffeine use.
- Smoking cessation strategies discussed if applicable due to impact on recovery.
- Surgeons may recommend a clear liquid diet for 1-2 days prior to surgery.
- There will be instructions to refrain from eating/drinking after midnight before surgery.
- They will provide guidance on medication adjustments before surgery.
RECOVERY
- Side effects after bladder removal surgery: sore throat, shivering, sleepiness, dry mouth, nausea, vomiting.
- Recovery time: several weeks to months, partial cystectomy patients recover faster.
- Healthcare teams encourage walking to promote healing and prevent complications.
- Recovery slower after radical cystectomy, extending hospital stays.
- Activity limitation for six weeks post-surgery.
- Follow-up appointments scheduled to monitor healing, urinary tract drainage, electrolyte imbalances.
- Managing an ostomy bag: emptying the bag, using mild soap, changing the pouch, applying ostomy powder.
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Cost estimation
Learn about the expenses involved in the procedure and what factors affect them.
- The cost of cystectomy in India ranges from ₹15,000 to ₹1,00,000, with an average of ₹60,000.
- Factors affecting the cost include consultation fees, diagnostic tests, type of surgery, admission fees, patient's medical condition and age, type of hospital, room selection, and location.
The average cost of Cystectomy in India is around ₹15,000 to ₹1,00,000.
₹1,00,000
High Cost
₹60,000
Average Cost
₹15,000
Low Cost
The LIST of AVERAGE COST of the Cystectomy across TOP 6 cities in India in Indian Rupee (INR) is as follows :
City
Lowest Cost
Average Cost
Highest Cost
Mumbai
₹ 50,000
₹ 60,000
₹ 70,000
Delhi
₹ 80,000
₹1,00,000
₹ 1,03,000
Chennai
₹ 45,000
₹ 50,000
₹ 75,000
Kochi
₹ 25,000
₹ 30,000
₹ 50,000
Kolkata
₹ 15,000
₹ 50,000
₹ 1,00,000
Hyderbad
₹ 70,000
₹ 75,000
₹ 88,000
Commonly Asked Questions
Is a cystectomy major surgery?
Yes, a cystectomy is major surgery as it involves the removal of all or part of your urinary bladder.
Can a person live without a bladder?
Yes, it is possible to live without a bladder, but you will need a new reservoir to hold urine produced by your kidneys. Adjustments may be needed, but many activities can still be performed post-surgery.
How long is a hospital stay for bladder removal?
Hospital stay duration varies depending on the type of cystectomy. Typically, for laparoscopic or robotic cystectomy, it's at least one day, while for open cystectomy, it can be up to a week.
Are there alternatives to a radical cystectomy?
Yes, alternatives like bladder preservation therapy using chemotherapy, radiotherapy, or a combination may be available. Discuss with your doctor to explore the best treatment option for you.
What risks are associated with a radical cystectomy?
Risks include bleeding, kidney issues, infection, and complications from urinary diversion due to the major nature of the surgery.
Should I be careful with what I eat or drink with a urostomy?
While drinking plenty of fluids like water is recommended, it's best to limit caffeine and alcohol. Hydration is important to lower the risk of infection.
When can I go back to work?
Most people can return to work after healing from the surgery. Heavy lifting may require precautions, such as wearing an ostomy support belt.
Sex and intimacy after a cystectomy?
Changes in sex life may occur, but most are temporary. Your doctor will provide guidance on when it's safe to resume sexual activity and address any concerns.
Can I travel with a urostomy?
Yes, with proper planning. Take extra supplies, inform airport security, and ensure supplies are kept in carry-on luggage, especially during air travel.
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