To help you prepare for a cystectomy, we’ve outlined the typical patient experience from initial consultation through surgery and follow-up care. If you have specific questions or concerns, feel free to ask your physician and other members of the Urology team.
Before surgery
Before your surgery is scheduled, you’ll have a detailed consultation with your physician to determine whether you’re a candidate for radical cystectomy. This consultation will include a physical exam, blood tests, a thorough review of your family and medical history, and a review of your pathology report and CT scan or MRI imaging.
When your surgery is scheduled, you'll also be scheduled for a preoperative appointment to consult with your anesthesiologist, as well as having an EKG (electrocardiogram), a chest x-ray, and possible additional lab tests. You will also receive any pre-surgical dietary or preparation instructions at this appointment. Expect to spend one to two hours for this pre-op exam.
You will also meet with a stomal therapy nurse who will help with planning for your urinary diversion. The particular type of urinary diversion (ileal conduit vs. orthotopic ileal neobladder) will be determined by you and your surgeon.
The day of surgery
The day of your surgery, you’ll meet with your doctors, nurses and anesthesiologist before your procedure. The surgery itself will take approximately 6 to 8 hours. For males, the entire bladder and prostate are removed during the procedure. For females, the bladder and uterus are removed.
After this a urinary diversion is created using an ileal conduit or an orthotopic ileal neobladder. For an ileal conduit, a piece of the ileum (small intestine) is used to create a “pipe” that connects to the surface of the skin and urine is directed to a urostomy bag worn on the outside of the body. For an orthtopic ileal neobladder, a portion of the ileum is used to create a new bladder within the body.
When the procedure is complete you may spend a day in intensive care or go directly to the post-operative ward. You will be able to drink fluids when your bowels have recovered from surgery, typically in three to five days.
During Hospitalization
Early after surgery you’ll be receiving intravenous pain medication. All of your medications will be given intravenously. Your diet will progress gradually from liquids to solids as your bowels recover. You can expect to spend between 5 and 7 days in the hospital.
After surgery
Your post-operative evaluation will occur between two and three weeks after your surgery. At this time, the pathology information from the surgery will be available for review.
About the orthotopic ileal neobladder
If you have received an orthotopic neobladder, the urinary catheter will be removed three weeks after surgery. With an orthotopic neobladder, you retain the ability to urinate through the urethra.
The best candidates to receive the neobladder are fit, relatively healthy adults who are able to care for possible complications such as urinary retention. If this occurs, patients may require intermittent catheterization to empty the neobladder.
Learn more
Read a sample consultation between a UCSD surgeon and a patient considernig robotic surgery
Watch a 52-minute presentation on the Advantage of Robotic Surgery
Mark Talamini MD, discusses the advantages of these new technologies and how they are best applied.