Cystectomy is a type of surgical procedure performed in case of invasive bladder cancer and, depending on the severity and extent of the cancer, it may be necessary to remove part or the entire bladder, in addition to other nearby structures, such as the prostate and seminal glands, in the case of men, and uterus, ovary and part of the vagina, in the case of women.
This surgery is done under general anesthesia and can be done through a cut of the abdomen or several small cuts through which a device that has a microcamera at its end passes.
When is indicated
Cystectomy is the type of treatment most indicated in case of bladder cancer that is found in stage 2, which is when the tumor reaches the bladder muscle layer, or 3, which is when it passes the bladder muscle layer and reaches the tissues around you.
Thus, according to the extent and severity of bladder cancer, the doctor can choose two types of cystectomy:
- Partial or segmental cystectomy, which is usually indicated in bladder cancer found in stage 2, in which the tumor reaches the bladder muscle layer and is well located. Thus, the doctor can choose to remove only the tumor or the part of the bladder that contains the tumor, without the need to completely remove the bladder; Radical cystectomy, which is indicated in the case of stage 3 bladder cancer, that is, when the tumor also affects the tissues near the bladder. Thus, the doctor indicates, in addition to the removal of the bladder, the removal of the prostate and seminal glands, in the case of men, and the uterus and wall of the vagina, in the case of women. In addition, depending on the extent of the cancer, it may also be necessary to remove women's ovaries, fallopian tubes and uterus, for example.
Although most women undergoing this type of surgery are already in menopause, many may still have an active sex life, and this factor is taken into account at the time of surgery. In addition, men of reproductive age should also bear in mind the consequence of surgery, since in radical cystectomy the prostate and seminal glands can be removed, interfering with the production and storage of semen.
How it is done
Cystectomy is performed under general anesthesia through a cut in the abdomen or through several small cuts, using a device that contains a microcamera at its end to view the pelvis internally, this technique being called laparoscopic cystectomy. Understand how laparoscopic surgery is performed.
The doctor usually recommends that the use of medications that may interfere with blood clotting be stopped and that the patient fast for at least 8 hours before surgery. After surgery, it is recommended that the person remains for about 30 days at rest, avoiding efforts.
In the case of partial cystectomy, surgery for bladder reconstruction is not necessary, however the bladder may not be able to contain much urine, which can make the person feel like going to the bathroom many times a day. However, in the case of radical cystectomy, surgery is necessary to build a new path for the storage and elimination of urine, as well as for reconstruction of the vaginal canal, in the case of women.
After surgery, it is normal for chemotherapy or radiation therapy to be indicated to prevent the proliferation of new tumor cells. In addition, it is normal to see blood in the urine, recurrent urinary tract infections and urinary incontinence, for example. Learn about other treatment options for bladder cancer.
