What is Partial Cystectomy

Partial cystectomy is a surgical procedure to remove part of the bladder. The bladder is the organ in the lower belly that holds urine until it is passed out of the body (urination).

You may have a partial cystectomy if you have bladder cancer in only one spot and the cancer has not spread too deeply into your bladder muscle.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have, including the possibility of pregnancy.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Injury to other organs in your belly.
• Leaking urine or having difficulty holding urine (incontinence).
• Blood clots that can break off and travel to other parts of the body.
• Cancer recurrence, if the procedure does not get rid of all of the cancer.

What happens before the procedure?

• Ask your health care provider if you should donate some of your own blood before surgery in case you need to receive blood (transfusion) during the procedure.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Plan to have someone take you home after the procedure.
• If you go home right after the procedure, plan to have someone with you for 24 hours.
• Do not drink alcohol or smoke cigarettes before your procedure as told by your health care provider.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given a medicine to make you fall asleep (general anesthetic).
• You may have a tube passed through your nose and into your stomach (NG tube).
• You may also have a narrow tube (catheter) inserted into your bladder to drain urine during and after surgery.
• Your surgeon will make an incision into your belly and down through the muscles to locate your bladder.
• The cancer will be removed.
• The incision in your bladder will be closed with stitches (sutures).
• Lymph nodes that are near your bladder may also be removed.
• Your surgeon will close your belly incision with sutures or staples.
• A bandage (dressing) will be placed over your incision.
• You may have a small plastic tube (surgical drain) placed so that fluid can drain away from the surgery site while it heals.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will be given pain medicine as needed. You may also get antibiotics and fluids through your IV tube.
• You will be encouraged to get up and walk around as soon as you can.
• Your IV tube and NG tube can be taken out after you can eat and drink on your own.
• Your catheter can be removed when you no longer need it to drain your urine.
• You may be sent home with a surgical drain. Your health care provider will give you instructions for caring for your drain at home.

Partial Cystectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Belly pain or soreness.
• The need to urinate often. This is because your bladder is smaller after surgery.

Follow these instructions at home:

Activity

• Do not douche or have sex until your health care provider says you can.
• Do not do exercises that put pressure on your abdominal muscles. These include sit-ups and weight lifting.
• Rest as told by your health care provider.

Incision care

• Follow instructions from your health care provider about how to take care of your incisions. Make sure you:
  • Wash your hands with soap and water before you change your dressing. If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Watch for:
  • Redness, swelling, or pain.
  • Fluid, blood, or pus.

General instructions

• Care for your catheter as told by your health care provider, if this applies.
• Care for your surgical drain as told by your health care provider, if this applies.
• Do not take baths, swim, or use a hot tub until your health care provider says you can.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important. If you have a catheter, you will need to have a procedure called a cystogram before your catheter is removed. In this procedure, dye is injected through your catheter and into your bladder, and then X-rays of your bladder are taken.
• Drink fluids to help flush your urine as told by your health care provider.

Contact a health care provider if:

• You have redness, swelling, or pain at your incision site.
• You have trouble starting or controlling urination.
• Your urine becomes cloudy or dark, or it smells bad.
• You have chills or a fever.

Get help right away if:

• You have bright red blood or blood clots in your urine.
• You have trouble breathing.
• You have fluid, blood, or pus coming from your incision.
• You cannot urinate.
• You have new abdominal pain and you also have:
  • Nausea.
  • Vomiting.
  • Trouble passing gas or stool.