Together is a new resource for anyone affected by pediatric cancer - patients and their parents, family members, and friends.Learn More
A cystectomy is an operation to remove the urinary bladder.
Two groups of cancer survivors may have undergone a cystectomy during their childhood cancer treatment:
After the bladder is removed, surgeons create a new passageway for urine to leave the body. This process is called diversion.
There are 3 main types.
Incontinent diversion is a passageway usually made through a loop of small intestine that is separated from the rest of the bowel. It is called an ileal conduit or urostomy.
The ileal conduit is connected to the outside of the abdomen by way of an opening called a stoma.
Internally, the ureters empty into the conduit. It serves as a pipeline for urine to flow directly through the stoma into a pouch worn outside the body.
In cutaneous continent diversion, an internal pouch (reservoir) is made from intestine and placed within the abdomen in front of the kidneys. The ureters are then connected to this pouch.
The appendix or another short piece of small intestine is used to create an extension from the pouch through the abdominal wall to the surface of the skin, often around the belly button. This opening is called a stoma.
Urine collects in the reservoir and removed several times a day by insertion of a catheter (tube) into the stoma.
This design prevents urine from flowing back into the kidney (reflux) or spilling out onto the skin.
The orthotopic neobladder procedure makes a new bladder (neobladder) from bowel.
The “neobladder” is connected directly to the urethra. Some people with a neobladder are able to urinate naturally. Others may require a catheter to empty the bladder.
Incontinence, or the inability to control passage of urine, may occur after a neobladder is created.
Bladder surgeries involving portions of the small intestine sometimes cause abnormal levels of chemicals and fats in the blood. These problems may result in diarrhea, kidney stones, and/or low levels of Vitamin B12.
Cystectomy may also increase the risk of sexual dysfunction in both men and women. Surgery and medications may treat this complication.
Reviewed: December 2019