The cancer operation
Radical cystectomy removes the bladder and usually regional lymph nodes. Removal or preservation of adjacent structures depends on the cancer, anatomy and surgical plan. Chemotherapy or other systemic treatment may form part of the wider treatment strategy.
Robotic surgery is one approach to performing this operation. Some patients are better served by a different approach.
Understanding urinary diversion
| Option | What it means |
|---|---|
| Ileal conduit | A short bowel segment carries urine to a stoma on the abdomen, with an external collection pouch. |
| Orthotopic neobladder | A bowel reservoir is connected to the urethra in suitable patients. Emptying requires learning a new routine; leakage or catheterisation may occur. |
Selection considers kidney function, cancer involvement, continence, dexterity and the ability to manage long-term care.
Preservation where appropriate
Dr. Sachin’s interests include intracorporeal urinary reconstruction and selected organ-preserving cystectomy in men and women. In some situations, reproductive structures or nerves may be retained if this is compatible with cancer control.
This is a discussion based on the individual case. It is not an automatic component of every cystectomy.
Preparing for life after surgery
Preparation should address nutrition, mobility, bowel recovery, stoma education or neobladder training, and support at home. Risks include bleeding, infection, bowel complications, urine leakage, thrombosis and later urinary obstruction or metabolic problems.
- Ask to discuss diversion options before the operation.
- Clarify the plan for catheters, stents and drains.
- Arrange training in the practical care you will need.
- Confirm pathology review and ongoing kidney and cancer surveillance.
Common questions
Can I pass urine normally after a neobladder?
A neobladder behaves differently from the original bladder. Training and scheduled emptying are important, and some people need intermittent catheterisation or have leakage.
Can I choose a conduit even if a neobladder is possible?
Yes. A well-informed decision includes your preferences and practical circumstances as well as surgical eligibility.