Bladder Removal Surgery in Johnson City, TN

What Is Bladder Removal Surgery?

A cystectomy is a surgical procedure which removes the urinary bladder. It is most often utilized to treat invasive or recurrent bladder cancer. Bladder removal surgery is also sometimes suggested for benign conditions, including nerve-muscle disorders that affect urinary control or birth defects.

There are two different bladder removal options:

• Partial cystectomy is a procedure used to remove only a portion of the bladder in cases where cancer has invaded the bladder’s muscle layer but is confined to one region. While used sparingly, the procedure is also used to treat more benign conditions because it can preserve natural urinary function.
• Radical cystectomy is a procedure that removes the entire bladder, nearby lymph nodes, and part of the urethra. The surgery aims to remove any tissues that may contain cancer cells; in men, the prostate, seminal vesicles, and part of the vas deferens are removed, while in women, the cervix, uterus, ovaries, fallopian tubes, and part of the vagina are removed. Reconstruction of the urinary tract is then necessary to create a safe storage and removal method for urine.

Due to the extensive nature of a cystectomy, it is not for everyone. If you suffer from bladder cancer, talk with your healthcare provider about whether or not this it the right option for you. To schedule a consultation with a healthcare practitioner in Johnson City who can discuss your treatment options, call (423) 482-8711 or contact Dr. Dalal Akoury online.

Who Can Benefit from a Cystectomy?

The goal of bladder removal surgery—especially radical cystectomy—is to prevent the spread or recurrence of certain cancers and increase your lifespan. While bladder removal surgery is usually performed to treat invasive or recurrent noninvasive bladder cancers, a cystectomy may also be used to treat:

• Birth defects that affect the urinary system
• Pelvic tumors, such as advanced colon, prostate or endometrial cancer
• Neurological or inflammatory disorders that affect the urinary system, such as interstitial cystitis

The kind of operation you undergo and reconstruction done afterward will depend on several factors, including:

• Your overall health
• Personal preferences
• The condition being treated
• The severity of the condition

What to Expect During a Cystectomy

Leading into a bladder removal procedure, your healthcare provider will evaluate your overall health to ensure you are well enough for surgery and review your current medications. Recommendations may be made to your lifestyle pertaining to caffeine, alcohol, drug or tobacco use.

Bladder Removal Procedure

For your bladder removal, general anesthesia is required. The actual cystectomy may be an open surgery or laparoscopic procedure. An open surgery requires a single-incision in the abdomen to access the pelvis and bladder. Laparoscopic surgery is minimally-invasive and requires smaller incisions than traditional open surgery, resulting in a quicker recovery. A laparoscopic cystectomy uses a laparoscope, a long tube with a viewing camera and involves several small incisions in the abdomen to remove the bladder. Sometimes, a robot is used to control the surgical instruments; this is known as a robotically assisted laparoscopic surgery. The use of a robot offers additional benefits, including improved precision, less blood loss, and fewer complications.

Urinary Tract Reconstructions for Radical Cystectomies

After the surgical removal of the bladder and other organs during a radical cystectomy, the surgeon will reconstruct your urinary tract. The goal of this reconstruction is to create a safe storage and release system for urine within the body while preserving your quality of life. There are several different types of reconstructions available:

• Ileal conduit: this procedure uses a piece of your small intestine to create a tube that attaches your ureters to an opening in your abdominal wall called a stoma. This stoma allows urine to flow continuously, and you wear a bag outside your body to collect the urine. 
• Neobladder reconstruction: A larger piece of your intestine is used to create a new bladder, placed in the same place as your original bladder. One end of the neobladder is attached to the ureters, while the other is attached to the urethra. This procedure may require a catheter to help remove urine.
• Continent urinary reservoir: A piece of the small intestine is used to create a small reservoir inside your abdominal wall. A catheter is then used to empty this reservoir several times a day.

Your healthcare provider will help you decide which reconstruction is best for you.

Bladder Removal Recovery and Risks

After your bladder removal operation, you will stay in the hospital for about a week. During this time, hospital staff will monitor the reconstruction to ensure that it is working properly. This rest will also give your organs time to recover and adjust to the modifications from surgery. You may be given medication to treat any pain or discomfort.

For the first six to eight weeks after returning home, you may experience bloody urine leaking that should improve in time. It is important to restrict your lifting, driving, bathing, working, or sexual activities during this time. You will need to make follow-up appointments to monitor your urinary tract function.

The cystectomy procedure is a complex operation involving many internal organs. Due to its alteration of the sexual organs and potential to cause nerve damage, a cystectomy may negatively impact sexual function, making it difficult for men to have erections and causing hot flashes and other menopause symptoms in women. Both men and women may also be infertile or find sex difficult.

Other risks and complications that can arise from the cystectomy surgery include:

• Dehydration
• Bleeding or blood clots
• Mucus in the urine
• Leaking urine or stool
• Heart attack
• Acidosis, an imbalance of electrolytes
• A bowel obstruction or ureter blockage
• Infections, such as pneumonia, kidney infections or a urinary tract infection

Additional operations may be needed to correct these complications. In rare cases, the surgery can be fatal.

If you are suffering from bladder cancer, bladder removal might be the best way to improve your quality of life, though it is not for everyone. To make an appointment with a healthcare practitioner in Johnson City who specializes in bladder removal surgery to learn about more about your options, call (423) 482-8711 or contact Dr. Dalal Akoury online.