Partial Cystectomy

What is a partial cystectomy?

A partial cystectomy is a procedure in which the surgeon removes part of your bladder, leaving enough of it so it can still hold enough urine for you to urinate comfortably.

When is it used?

This procedure is used only when you have a cancerous tumor in your bladder that is not too large and is in a place where it can be removed without hurting bladder function. A partial cystectomy is rarely performed because in most cases bladder cancer involves several sites in the bladder and the risk of the cancer returning is much higher when part rather than all of the bladder is removed.

Examples of alternatives to this procedure are:

• removing all of the bladder (a simple or radical cystectomy)
• having radiation therapy or chemotherapy
• using a laser or electric current to remove the cancer
• choosing not to have treatment while recognizing the risks of your condition.

You should ask your healthcare provider about these choices.

How do I prepare for a partial cystectomy?

Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.

Follow your provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For these reasons, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery.

If you need a minor pain reliever in the week before surgery, choose acetaminophen rather than aspirin, ibuprofen, or naproxen. This helps avoid extra bleeding during surgery. If you are taking daily aspirin for a medical condition, ask your provider if you need to stop taking it before your surgery.

Follow any other instructions your healthcare provider may give you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You will be given general anesthesia. A general anesthetic will relax your muscles and put you to sleep. It will prevent you from feeling pain during the operation.

The surgeon will make a cut (incision) in the lower part of your abdomen to expose the bladder and tie off the blood supply to the area. The surgeon will remove the affected part of the bladder and sew the remaining part closed, then close the cut.

What happens after the procedure?

• You may be in the hospital for 1 to 5 days.
• A catheter will be used to drain urine while the bladder heals.
• The cut in your abdomen may drain for a few days.
• After removal of the catheter, your bladder may not hold as much urine as it used to, and you may need to urinate more often. Over time, though, the bladder usually stretches and can hold more urine.

Ask your healthcare provider what steps you should take and when you should come back for a checkup.

What are the benefits of this procedure?

The cancer in the bladder may be removed without loss of your bladder.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
• Urine may leak from the cut in the bladder.
• The ureters (the tubes that drain urine from the kidneys to the bladder) may be damaged.
• One or both ureters may need to be reattached to the bladder.
• The intestines could be damaged and require surgical repair.
• The operation may not remove all of the cancer, and the cancer may grow back.
• You may have bleeding and infection.

You should ask your healthcare provider how these risks apply to you.

When should I call the healthcare provider?

Call your provider right away if:

• Your catheter is not draining well.
• You develop a fever.
• You develop nausea or vomiting.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.