Cystectomy
What is Cystectomy ?
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Why do you need Cystectomy ?
Cystectomy is indicated for:
- Bladder cancer:
- Muscle-invasive bladder cancer (MIBC, stages T2–T4; 20–25% of bladder cancer cases).
- High-risk non-muscle-invasive bladder cancer (NMIBC, as in your TURBT query) that fails BCG therapy.
- Incidence in India: 2–3 per 100,000; more common in men.
- 5-year survival: 50–70% for MIBC (stage II–III); 10–15% if metastatic (stage IV).
- Benign conditions (less common):
- Interstitial cystitis (chronic bladder pain, unresponsive to treatment; rare indication).
- Radiation cystitis or severe neurogenic bladder (e.g., spinal cord injury).
- Associated treatments:
- Neoadjuvant chemotherapy (e.g., cisplatin-based) for MIBC to improve survival.
- Lymph node dissection (pelvic lymphadenectomy) for cancer staging.
- Urinary diversion: Ileal conduit, neobladder, or continent pouch to manage urine post-op.
- Timing:
- Performed in adults (average age 60–70 years for cancer); urgency depends on cancer stage.
The procedure aims to remove cancerous tissue, prevent metastasis, and manage symptoms, often requiring urinary reconstruction, with significant lifestyle adjustments post-surgery.
Why Do Costs Vary in Philippines?
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Cystectomy Procedure
- Before Surgery Evaluation:
- Assessment:
- Cystoscopy/biopsy: Confirms cancer invasion (muscle layer).
- Imaging: CT/MRI to stage cancer and check for metastasis (e.g., lymph nodes, lungs).
- Blood tests: Kidney function (creatinine), blood sugar, clotting profile.
- Preparation: Neoadjuvant chemotherapy (3–4 cycles, if indicated); bowel prep for urinary diversion.
- Consent: Risks, including urinary diversion complications, are explained.
- Assessment:
- Surgical Techniques:
- Cystectomy:
- Performed under general anesthesia, lasting 4–8 hours.
- Types:
- Radical cystectomy: Removes entire bladder, nearby lymph nodes, and surrounding organs (prostate/seminal vesicles in men; uterus/ovaries in women); standard for MIBC.
- Partial cystectomy: Removes part of bladder; rare, for select cases (e.g., single tumor, no CIS).
- Simple cystectomy: Removes bladder only; for benign conditions (rare).
- Approaches:
- Open cystectomy: Large incision (15–20 cm) in lower abdomen.
- Laparoscopic/robotic: 4–5 small incisions (5–10 mm); camera and instruments used; less invasive.
- Process:
- Bladder isolated; ureters detached; bladder and surrounding tissues removed.
- Lymph nodes: Pelvic lymphadenectomy (10–20 nodes) for staging.
- Urinary diversion:
- Ileal conduit: Most common; small intestine segment used to create a stoma (urine drains into external bag).
- Neobladder: Intestine used to create a new bladder; patient voids via urethra (select patients).
- Continent pouch: Internal reservoir; patient catheters to drain urine.
- Closure: Sutures/staples; drains placed to prevent fluid buildup.
- Intraoperative Tools:
- Robotic system (e.g., da Vinci): Enhances precision.
- Endoscopic clips: Secures vessels.
- Ureteral stents: Maintain ureter-bladder connection during healing.
- Cystectomy:
- After Surgery:
- Hospital stay: 5–10 days.
- Care: ICU for 1–2 days; stoma care education (ileal conduit); catheter for 2–3 weeks (neobladder).
- Pain management: Moderate pain for 5–7 days; managed with painkillers (e.g., paracetamol).
- Instructions: Avoid heavy lifting for 6–8 weeks; monitor kidney function and stoma output.
Recovery After Cystectomy
- Hospital Stay: 5–10 days.
- Post-Surgery Care:
- Pain/Swelling: Moderate pain for 5–7 days; resolves in 2–3 weeks.
- Urinary diversion: Stoma care (ileal conduit) or catheter use (neobladder) training; adapts over 4–6 weeks.
- Activity: Avoid strenuous activity for 6–8 weeks; light activities in 2–3 weeks.
- Incision: Sutures removed in 10–14 days; scar fades in 6–12 months.
- Diet: High-protein diet to aid healing; hydrate well to prevent urinary infections.
- Follow-Up:
- Visits at 1 week (check healing), 1 month, and every 3 months for 2 years (recurrence risk).
- Imaging: CT at 3–6 months to monitor for recurrence; kidney function tests (creatinine) ongoing.
Most resume normal activities in 6–8 weeks; full adaptation to urinary diversion takes 3–6 months. Success rate: 5-year survival for MIBC is 50–70% (stage II–III); 10–15% for stage IV.
Risks and Complications
- Surgical Risks:
- Bleeding (3–5%): During surgery; may need transfusion.
- Infection (5–10%): Wound or UTI; treated with antibiotics.
- Anesthesia risks (<1%): Reaction to anesthesia; rare in healthy patients.
- Post-Surgery:
- Urinary leak (2–5%): From diversion site; may need surgical repair.
- Bowel obstruction (3–5%): From intestinal use; may need surgery.
- Ureteral stricture (2–3%): Narrowing at ureter-intestine junction; may need stents.
- Erectile dysfunction (50–70%, men): Nerve damage; managed with medications (e.g., sildenafil).
- Long-Term:
- Recurrence (30–50%): Cancer return (local or metastatic); needs regular imaging.
- Kidney dysfunction (5–10%): From ureteral obstruction; monitor creatinine.
Report fever, severe pain, decreased urine output, or stoma issues promptly.
Frequently Asked Questions (FAQs)
What causes the need for cystectomy?
Muscle-invasive bladder cancer, high-risk NMIBC (failed BCG), or severe benign conditions (e.g., interstitial cystitis).
Can I avoid cystectomy?
Yes, if early: Bladder-sparing (chemo/radiation) for select MIBC cases; surgery needed for advanced cancer or failed therapies.
Is cystectomy painful?
Moderate pain for 5–7 days, managed with medication; resolves in 2–3 weeks.
How soon can I resume normal activities?
Light activities: 2–3 weeks; full recovery: 3–6 months; avoid strenuous activity for 6–8 weeks.
Is cystectomy covered by insurance in India?
Often covered (medical necessity); confirm with your provider; Ayushman Bharat often subsidizes.
Signs of complications?
Fever, severe pain, decreased urine output, or stoma issues.
How will I urinate after surgery?
Via stoma (ileal conduit, external bag), neobladder (void via urethra), or catheter (continent pouch); adapts over 3–6 months.
Lifestyle changes post-surgery?
Manage urinary diversion, stay hydrated, monitor for infections, and attend follow-ups.
Conclusion
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Looking for Best Hospitals for Cystectomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.