What is a cystectomy?
Cystectomy can be performed openly, i.e. via an abdominal incision, or via a probe (endoscopic cystectomy).
Reconstruction of the bladder after cystectomy
Since the bladder can no longer hold urine, the drainage of urine after surgery must be ensured. Procedures such as the neobladder or the ileum conduit are used for this purpose.
When do you perform a cystectomy?
Simple cystectomy, in which only the urinary bladder is removed, is necessary for the following conditions:
- Interstitial cystitis (chronic inflammation of the bladder).
- Chronic bladder inflammation after radiation (radiation cystitis).
- Superficial bladder tumors
- Bladder dysfunction that cannot be corrected by other therapies
What is done during a cystectomy?
The urinary bladder is a hollow organ located behind the pubic bone. It serves as a collection point for urine formed in the kidney. It can be divided into the following sections:
- Bladder tip (anterior upper part of the bladder)
- Bladder body
- bladder neck (with transition into the urethra)
- Bladder base (posterior lower bladder part)
Before cystectomy
In the operating room, the surgeon carefully disinfects the surgical area and covers it with sterile drapes. The abdominal region is left out.
Simple cystectomy: The operation
Once the doctor has removed the organ, he carefully stops any bleeding by tying off the small vessels with a thread or sclerosing them – that is, inducing artificial scarring with special drugs. The entire operation usually takes between two and a half and four hours. Reconstruction of the urinary bladder, for example with an ileum conduit, is usually done during the same procedure.
After cystectomy
What are the risks of cystectomy?
Removal of the bladder is the standard procedure in the treatment of a bladder tumor growing into the muscle. As with any procedure, there are some surgical risks:
- Injury to the rectum
- Scattering of tumor cells
- Lymphatic congestion
- Intestinal inertia (atony)
- Leaky sutures (especially in case of ileum conduit installation)
- Formation of abscesses
- Hernia (scar hernia)
- Disturbed sexual function when the corresponding nerves are severed
- Bleeding during or after surgery
- Formation of a hematoma, possibly with the need for surgical evacuation
- Blood preservation with corresponding risk of infection
- @ Injury to nerves and soft tissues as well as surrounding organs
- Infections
- Allergic reaction to materials used (latex, drugs and the like)
- Anesthetic incidents
- Aesthetically unsatisfactory scar healing
What do I need to be aware of after a cystectomy?
Personal hygiene after cystectomy
After the operation, the wound must not become moist in order to prevent infections. Therefore, you should not bathe or take a sauna until three weeks after the cystectomy. Showering is allowed, however; here it is recommended to carefully dab the wound dry with sterile compresses after showering. Alternatively, you can also use a special shower plaster from the pharmacy.
Medication after cystectomy
There is noticeable wound pain, especially in the first few days after surgery. If necessary, your doctor will prescribe an analgesic medication.
During the first two weeks after the cystectomy, you should take it easy on yourself physically and engage in only a few strenuous activities (walking, simple exercises).
