Partial cystectomy is surgery to remove part of the bladder. It is most often done to treat bladder cancer. If the cancer is found at an early stage, this surgery may help cure it. After the surgery, the bladder will still function.
Preparing for surgery
Prepare for the surgery as you have been told. In addition:
Tell your doctor about all medicines you take. This includes prescription, over-the-counter, herbs and other supplements. It also includes any blood thinners, such as warfarin, clopidogrel, or daily aspirin. You may be told to stop taking some or all of them before surgery.
Do not eat or drink during the 8 hours before your surgery. This includes coffee, water, gum, and mints. (If you have been instructed to take medicine, take them with a small sip of water.)
If you have been told to, prepare your bowel for surgery (“bowel prep”). This process begins 1 to 2 days before the surgery. Your doctor may tell you to restrict your diet to clear liquids. You may also be asked to take laxatives or to give yourself an enema. Follow all instructions you are given.
The day of surgery
The surgery takes 4 to 6 hours. Afterward, you will stay in the hospital for 3 to 5 nights.
Before the surgery begins:
An intravenous (IV) line is put into a vein in your arm or hand. This delivers fluids and medicines (such as antibiotics). In some cases, a central or arterial line is inserted into a blood vessel somewhere else on the body. Your doctor can tell you more.
To keep you free of pain during the surgery, you’re given general anesthesia. This medicine lets you sleep comfortably through the surgery. A tube may be inserted into your throat to help you breathe.
You may be given a medicine to prevent blood clots in your veins.
You may have an epidural to help control post-surgery pain. A small tube is inserted into your back to deliver pain medicine that numbs the lower body. Talk to your doctor or anesthesiologist about this option.
A thin tube is passed into your bladder through your urethra (the tube that grains urine from the bladder). This is called a Foley catheter. It drains your urine during the surgery and for a time afterward.
During the surgery:
An incision is made in the lower abdomen to expose your bladder.
Nearby lymph nodes may be removed. These are checked for cancer cells (a sign that the cancer has spread).
The part of the bladder that contains cancer is removed. A margin of healthy tissue is also removed. The bladder is closed with stitches.
The skin incision is closed with stitches or staples.
A small tube may be placed in the abdomen. This drains blood and fluid as the wound begins to heal.
In some cases, a thin tube may be placed into your bladder through a small incision in your abdomen. This is called a suprapubic catheter. Like the Foley catheter, this tube also helps drain your urine.
Recovering at the hospital
After the surgery, you will be taken to a recovery room where you will be monitored while you wake up from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. When you are ready, you will be taken to your hospital room. While you’re in the hospital:
You will be given medicine to manage pain. Let your providers know if your pain is not controlled.
You’ll get IV fluids until you can start on a liquid diet. You’ll then slowly return to a normal diet.
As soon as you’re able, you’ll get up and walk.
You will be shown coughing and breathing techniques to help keep your lungs clear and prevent pneumonia.
If you are sent home with a catheter or drains, you will be shown how to care for them.
Recovering at home
After your hospital stay, you will be released to an adult family member or friend. Have someone stay with you for the next few days, to help care for you. Recovery time varies for each person. Your doctor will tell you when you can return to your normal routine. Until then, follow the instructions you have been given. Make sure to:
Take all medicines as instructed.
Care for your incision as instructed. If you go home with catheters or drains, take care of these as you were shown.
Follow your doctor’s guidelines for showering. Don't swim, bathe, use a hot tub, or do other activities that cause the incision to be covered with water until the doctor says it’s OK.
Don't lift anything heavy or do strenuous activities, as directed.
Don't drive until your doctor says it’s OK. Don't drive if you’re taking medicine that make you drowsy or sleepy.
Walk a few times daily. As you feel able, slowly increase your pace and distance.
Don't strain to pass stool. If needed, take stool softeners as directed by your doctor.
Drink plenty of water. This helps prevent urine odor and dehydration.
When to call your healthcare provider
Call your healthcare provider right away If you have any of the following:
Chest pain or trouble breathing (call 911)
Fever of 100.4°F (38°C) or higher, or as directed by your healthcare provider
Increasing pain, redness, swelling, bruising, bleeding, or drainage at the incision site
Pain that worsens or that is not controlled with pain medicine
Little or no urine for longer than 4 hours
Leakage around the catheter
Burning or pain when passing urine (after the catheter is removed)
Frequent need to pass urine
Blood clots in the urine (some pink-tinged urine is normal)
Problems with catheters or drains
Pain or swelling in the legs
You will have follow-up visits so your doctor can check how well you’re healing. Any drains, catheters, and stitches you have will be removed. If you had cancer, you will have regular testing to make sure you remain cancer-free. Your doctor can tell you more.
Risks and possible complications
Bleeding (may require a blood transfusion)
Blood clots in the legs
Pneumonia or other lung problems
Urine leakage at the site of bladder incision
Damage to nearby nerves, tissues, or organs
Bladder may not hold as much urine as before
Failure to remove all cancerous tissue, or cancer comes back
Risks of anesthesia (the anesthesiologist will discuss these with you)
November 13, 2017
Wein, Campbell-Walsh Urology (2012); 10th ed; pp 2375-2385
Greenstein, Marc, DO,Sather, Rita, RN