Cystectomy and Types of Urinary Diversions
If your doctor has told you that a Radical or partial Cystectomy is needed you will of course have many questions.
The good news is that for after healing and adjustment has taken place most lead very normal lives.
Cystectomy is the removal of the bladder and reconstruction is the making of a urinary diversion.
What you read here is to help you form questions for your health team, that will help you understand your own unique situation.
You can read about people’s personal stories following Cystectomy by searching terms in our forum as well as posting your questions there.
Common Types of Urinary Diversions
Please note not all diversions are available to all as individual situations differ.
- Ileal Conduit: Urinary diversion that allows urine to drain through a stoma into an external bag affixed to the abdomen. This is the most common of the diversions used by many general urologists.
- Continent Diversions Indiana Pouch: Continent urinary diversion made of harvested intestine formed into an internal pouch that allows urine to collect and then be drained using a catheter inserted into a stoma located on the abdomen or in the navel.
- Neobladder: Urinary diversion that uses harvested intestine to form an internal pouch that allows urine to collect and be voided normally though the urethra.
Types of Urinary Cystectomy are
- Partial Cystectomy: This is a procedure where only a part of the urinary bladder is removed. The most common use for partial cystectomy is used for a type of bladder cancer called adenocarcinoma. Partial Cystectomy is rarely used in the treatment of Transitional Cell Carcinoma as the likelihood of recurrence in the remaining bladder is high.
- Simple Cystectomy: Removal of the urinary bladder followed by urinary reconstruction commonly used for conditions other than bladder cancer.
- Radical Cystectomy: A Radical Cystectomy is when the urinary bladder is removed and typically includes removal of some lymph nodes. Everyone’s situation differs and you should discuss with your medical team the plan they have for your surgery.
- Radical Cystectomy and Women: In women a Radical Cystectomy may include the removal of the uterus, ovaries, fallopian tubes, cervix, and front wall of the vagina.
- Radical Cystectomy and Men: In men Radical Cystectomy typically includes removal of the prostate and seminal vesicles
Nerve sparing radical cystectomy is an option dependent on each individual’s situation. In this procedure the nerve bundles that control erection in men and orgasm in women are spared. You will need to talk to your medical team to ascertain the possibility of using this procedure in your personal case. If this is an important part of your life a frank discussion between you and your medical team about your sexuality and what can be done to preserve your function should happen prior to your radical cystectomy.