You want a surgeon that has done this operation many times. This is a real specialty. I was fortunate in that my insurance, Ventura County Health Care, has some kind of association with UCLA. The Clark Urology center at UCLA is ranked #3 in the country for urology related operations. On the day before Thanksgiving in 2016 I had a piece of tumor removed from my bladder because I was peeing blood. It turned out to be an aggressive stage 3 tumor that had penetrated the muscle wall of the bladder. The Urologist who did the operation recommended that I have a radical cystectomy performed laparoscopically. Ventura County Medical Center does not do this operation, and they referred me to UCLA.
I had six weeks of pre-operative chemo, which I weathered quite well. My operation was on March 31st. They removed my bladder, prostate and surrounding lymph nodes. and made a neo-bladder with a piece of intestine. The following pathology report indicated they got all of the cancer. I was in the hospital at UCLA for a week and I was very impressed with the level of care. I only experienced minor pain, which is amazing, considering what they had done. I was home for about a week, when I felt very week. Home health care came to my house immediately, measured my blood pressure at 60/30, and sent me to the local hospital. I had acute renal failure - my kidneys stopped working. They put a drain in my abdomen and drained about 2 quarts of fluid - I am not kidding.
I went back home after about a week. I was very feeble for a couple of weeks, and that was a life changing experience. Old people who do not stay fit become feeble like this. They usually fall and suffer greatly from it. I swore I would stay fit from now on.
During my recovery, I lost 45 pounds. I had zero appetite and food hurt going down my trachea. I think it was because I was intubated for over eight hours during the neobladder surgery.
It is now four months since my surgery. I am 6'2", and went from 230 pounds to 180 pounds. My blood sugar dropped to where I am no longer diabetic. My blood pressure, with only Atenolol, a mild blood pressure medication, stays close to 120/80. I no longer have Sleep Apnea. My appetite is back 100%, but I eat to stay in the 180 pound range. As far as my commitment to stay fit, I have a workout on DVD that I use every day. I take a Pilates class twice a week. An I take my doggies to an off-leash park every day and walk four laps around the perimeter. I am in much better shape than before the operation. I am in physical therapy for incontinence. During the day, as long as I void every two hours or so, I stay fairly dry. Night is a different story. I tried getting up every two hours but this made me a zombie during the day. So now I get up every four hours. I often wake up with Depends soaked with five pound of urine, but I put absorbent pads with waterproof backings on my bed. I simply throw them out. The incontinence is a pain in the butt but it is not serious. I am grateful they removed all the Cancer.
My advice to anyone who is going to undergo this surgery is get in as good a shape as possible before the operation. No matter how far you have to travel, go to a surgeon that has done this surgery laparoscopically many times. And be patient with yourself during recovery. It takes quite a while, but you do get back to where you can do normal everyday activities again.