Cystectomy is a medical procedure which is most commonly performed in people who are suffering from bladder cancer. Cystectomy actually refers to partial or complete removal of the bladder. Partial cystectomy is the resection of only one part of the bladder. It is convenient surgical modality in case that cancer has affected only one localized area of the bladder. On the other hand radical cystectomy includes the removal of the entire bladder and the surrounding lymph nodes. Radical cystectomy in men also includes the removal of the prostate, seminal vesicles and partial removal of vas deferens. In women radical cystectomy also includes the removal of the entire uterus together with its cervix, ovaries, fallopian tubes and upper part of the vagina.
The recovery time after cystectomy lasts approximately 8 weeks. After the bladder has been removed the surgeon has to make a new path for the urine. The path will eliminate the urine from the body. A surgeon has to make an opening on the abdomen. The opening requires additional material and it can be obtained from the intestines. This way ureters are connected to the opening called urostomy and the urine can be successfully eliminated from the body. The urine collects into the specific bag which is attached to the urostomy. In some patients a continent reservoir is actually created inside their bodies. Again part of the intestines is used to create a pocket which will collect urine. This artificial pocket is placed inside the abdominal cavity. A continent reservoir may be created as abdominal diversion reservoir or orthotopic diversion. In abdominal diversion reservoir the urine is eliminated from the body through urostomy. In other option, orthotopic diversion, there is a connection among the ureters, the reservoir and the urethra and this way a patient may urinate the same way he/ she did prior the surgery.
Complications of Radical Cystectomy
Acidosis is a complication which develops due to improper balance of certain electrolytes. It features with disturbance of the level of calcium and potassium. Acidosis is actually a consequence of creation of the urine reservoir by usage of the intestines. This potential complication can be brought under control by certain medications.
Urine leak is another possible complication. It occurs due to improper stitching and it can cause infections. If urine leak occurs one may have to be re-operated. Infections are prevented with antibiotics, but people who have undergone radical cystectomy are generally prone to infections. Fistula is another possible complication of radical cystectomy. It requires additional correction surgery. In some patients, even obstruction of large intestines may occur. And finally, during the surgery the rectum and surrounding structures can be damaged. Men who have undergone cystectomy can suffer from problems with erection if nerves that are in charge with this function have been damaged during the surgical procedure.