Cystectomy is a surgery that involves the removal of the urinary bladder. It is commonly performed when cancer is found in the bladder, particularly in cases of bladder cancer. The bladder is a hollow organ that holds urine produced by the kidneys before it is excreted from the body. Once the bladder is removed, a new pathway must be created for the urine to leave the body, referred to as urinary diversion. The blog by a gynecologist in Delhi from Manasvi Healthcare explains all neccesary details about this surgery for females below. 

Types of Cystectomy

There are primarily three types of cystectomy:

1. Radical Cystectomy

A radical cystectomy is the complete removal of the bladder and is often recommended for individuals with bladder cancer that has spread to the muscle layer of the bladder. In this procedure, the surgeon not only removes the bladder but also nearby lymph nodes, as these may contain cancerous cells.

In women, the surgeon may remove the uterus, ovaries, fallopian tubes, cervix, and sometimes part of the vagina, depending on the spread of the cancer. This is done to ensure that all cancerous tissues are removed.

After removing the bladder, a surgeon must create a new way for urine to leave the body. This is called urinary diversion. Some common options include creating a neobladder (an internal bladder made from a portion of the intestine) or using an ileal conduit (a piece of the small intestine connected to the ureters, creating a stoma on the abdomen). Both options allow urine to pass out of the body but with different mechanisms.

2. Partial Cystectomy

A partial cystectomy is when only part of the bladder is removed. This type of surgery is less common than radical cystectomy and is usually only performed when the cancer is localised to one area of the bladder. The surgeon removes the tumour or affected section of the bladder and may also remove a portion of the bladder wall.

One of the main benefits of partial cystectomy is that it allows the patient to keep the rest of the bladder intact. As a result, they can continue passing urine in the usual manner. However, since the remaining bladder is smaller, the patient may need to urinate more frequently.

For those who undergo this gynae surgery, the risks of complications are lower than those associated with a radical cystectomy. However, the cancer may return, which means close monitoring and follow-up treatments are essential.

3. Ovarian Cystectomy (Related but Different Procedure)

While ovarian cystectomy is a procedure related to the removal of cysts from the ovaries and not the bladder. An ovarian cystectomy involves the removal of cysts from the ovaries, typically performed by a gynecologist in rohini or other specialists. If you’re experiencing symptoms of ovarian cysts, such as pain or irregular periods, this procedure might be considered by your doctor.

Although the term “cystectomy” is used in both procedures, it’s important to distinguish between bladder cystectomy and ovarian cystectomy, as they are entirely different surgeries aimed at treating different conditions.

Laparoscopic Cystectomy

In recent years, many cystectomy surgeries have been performed laparoscopically, a minimally invasive approach that uses small incisions and special tools. A laparoscopic surgery is performed with or without robotic cystectomy. This technique has several advantages over traditional open surgery, including:

• Smaller incisions, which lead to less pain after surgery
• A faster recovery time
• Reduced risk of infection
• Less blood loss

In a laparoscopic cystectomy, the surgeon makes small cuts in the abdomen and uses long, thin instruments to perform the procedure. A small camera is often used to guide the surgeon, allowing them to perform the surgery. 

Preparation for Cystectomy Surgery

Before undergoing surgery, your surgeon will review your medical history and conduct a series of tests to ensure you’re in good overall health. You may need to stop taking certain medications, especially blood thinners, to reduce the risk of bleeding during surgery.

You may be asked to follow specific dietary instructions in the days leading up to your procedure, such as fasting or eating clear liquids. Your surgeon will also explain any steps you need to take to prepare your bowel for surgery, as the colon or small intestine may be used to create a new pathway for urine.

Recovery and Post-Operative Care

Cystectomy is a major surgery, and recovery time can vary. After a radical cystectomy, you may need to stay in the hospital for up to a week. Recovery from laparoscopic surgery take less time, and many patients can go home within a few days.

After surgery, you will likely experience some pain and discomfort, but your gynae surgeon will provide pain relief options. If you’ve had a neobladder or other type of urinary diversion, you will need to adjust to a new way of passing urine. Some people may experience leaking urine or have difficulty sensing when they need to urinate with a neobladder. 

Risks of Cystectomy

Like any major surgery, cystectomy comes with risks, including:

• Infection
• Blood clots
• Injury to nearby organs
• Complications related to urinary diversion, such as blockage or leakage

In the case of radical cystectomy, you may also experience sexual side effects, such as erectile dysfunction in men or loss of sexual sensations in women. 

If you need a gynae in Rohini or an obstetrician in Delhi, consider meeting a specialist at Manasvi Healthcare, one of the well known maternity and female specialist clinic in the North West Delhi.