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Cystectomy (Bladder Removal)

What is a cystectomy?

A cystectomy is a surgery (operation) to remove all or part of the urinary bladder, an organ in the pelvic area, just below the belly button. The bladder stores urine (pee), which travels out of the body through a tube-like structure called the urethra.

Urinary system showing kidney, ureter, bladder, and urethra

A cystectomy is a surgery to remove all or part of the urinary bladder.

There are 3 main types of cystectomy surgeries: 

  • Partial cystectomy: Only part of the bladder is removed and any affected lymph nodes if cancer is present 
  • Simple cystectomy: The whole bladder is removed 
  • Radical cystectomy: The whole bladder is removed, and, if needed, nearby organs such as reproductive organs or lymph nodes  

After cystectomy surgery, patients may also have a procedure that makes a new way for urine (pee) to drain from the body. This is a procedure called a urinary diversion. 

Patients will need regular follow-up care after this surgery.

Reasons for cystectomy

Common reasons a person may need a cystectomy include: 

  • Bladder cancer 
  • Benign tumors (not cancer) 
  • Problems with the bladder such as: 
    • Swelling and bleeding in the bladder (hemorrhagic cystitis) 
    • Scar tissue in the bladder (bladder fibrosis) 

Before the cystectomy

Your care team will talk with you about the risks and benefits of a cystectomy. You will also meet with members of the surgery team to discuss the surgery and get instructions on how to prepare for it.  

Be sure to let your care team know about any medicines you are taking, including over-the-counter medicines. 

The care team will give you instructions about when to stop eating and drinking before the procedure. These guidelines are also known as NPO instructions. They will also let you know about any changes you need to make to your medicines before the surgery. 

Always follow your care team’s instructions and ask any questions you may have. 

During a cystectomy

How long the surgery takes will depend on how much of the bladder will be removed and how the surgery is done. In general, the procedure involves:

  1. Anesthesia

    You will receive general anesthesia before your surgery. The anesthesia will make you lose consciousness, like a deep sleep. You will not feel pain during your surgery. 

  2. Surgery

    Cystectomy surgery will be done 1 of 3 ways:  

    • Open cystectomy: The surgeon makes an incision (cut) in the belly to remove part or all of the bladder and any affected lymph nodes or nearby organs if needed. This may be done if a bladder tumor is large or if cancer has spread to other areas.  
    • Laparoscopic cystectomy: This procedure uses several small incisions. Your belly is inflated with carbon dioxide gas to make room for surgical instruments. A small medical instrument (laparoscope) with a camera and light at the end is inserted to see inside the belly. A part or all of the bladder is removed. Recovery is often faster and may be less painful than surgery with a bigger incision.   
    • Robot-assisted cystectomy: This is like laparoscopic surgery, but the surgeon uses robotic arms to move tiny instruments with precise movements. This kind of surgery may reduce blood loss, pain, and scarring. It often has a shorter recovery time. 

  3. Urinary diversion

    Because the bladder was removed, the surgeon will need to make a new way for urine to drain from the body (urinary diversion).  There are 3 types of diversions:   

    • Incontinent diversion: In a surgery called a urostomy, the surgeon makes a new opening (stoma) in the belly so the urine can go from the kidneys to a pouch (bag) worn outside the body. Your care team will teach you how to empty, clean, and change the pouch.  
    • Cutaneous continent diversion: Urine is stored in a pouch inside the body. This internal pouch is connected to a stoma (an opening on the outside of the body). Your care team will teach you how to use a urinary catheter to drain urine from the pouch.  
    • Orthotopic neobladder: The surgeon makes a new bladder (neobladder) from the bowel. Some people can urinate naturally after this surgery. Others may need a catheter to drain urine from the bladder.  

  4. Closure

    Your incisions will be closed with staples or stitches, then covered with a dressing.

After a cystectomy

After the surgery, the recovery time will depend on the type of surgery and how it was done.   

Follow-up care after cystectomy includes: 

  • Watching for any complications, like bleeding or infection 
  • Pain management 
  • Caring for the incision site 

Your care team will teach you how to do home care after the surgery. Follow these instructions carefully and be sure to ask any questions you have.  

Recovery time may be different for each patient. Talk to your doctor about what to expect. Your care team can let you know when you can return to your usual activities.

Possible risks of a cystectomy

A cystectomy, like any surgery, has some risks. These include: 

  • Damage to nearby organs 
  • A reaction to the anesthesia 
  • Bleeding 
  • Blood clots 
  • Infection 
  • Problems with the bowel or kidneys 

Diversion complications 

Other complications may happen due to the urinary diversion procedure. These include: 

Problems with external and internal pouches such as: 

  • Urine leaks 
  • Skin irritation 
  • Infection 
  • Scar tissue that may block the flow of urine   
  • Urine flow back into the kidney (reflux). This increases the risk of a urinary tract infection (UTI) or kidney stones. 

Incontinence: If you have a neobladder, you may have trouble controlling when your urine comes out. This is called incontinence. Your care team may do tests to see how well the bladder stores and releases urine. Pelvic muscle-strengthening exercises may help.   

Changes in nutrient and chemical levels: If part of your small intestine was removed, you may have changes in how your body uses nutrients. This can cause: 

  • Diarrhea 
  • Kidney stones (crystals made of minerals from the kidneys) 
  • Low levels of vitamin B12 

Sexual problems: Cystectomy may increase the risk for sexual problems in the future, such as erectile dysfunction in men, and problems with arousal or painful sex in women. Surgery, medicines, or other treatments may help. 

Living without a bladder

You will need to take steps to manage your health after a cystectomy. Tips for care after cystectomy include: 

  • Keep all medical appointments and see your urologist regularly. A urologist is a doctor who diagnoses and treats urinary system problems. You may also see an enterostomal therapy (ET) nurse for help caring for your urinary catheter and stoma.   
  • If you had part of your small intestine removed, you may need regular blood tests to check vitamin B12 levels.   
  • Drink fluids and stay hydrated. 
  • Eat a healthy diet. 
  • Watch for problems and seek medical care right away if you have problems with your catheter or stoma or notice signs of infection. 

Always follow the instructions given by your health care provider.  

When to call your care team

Get medical help if you develop  signs of an infection or other symptoms. An infection can be life-threatening if not treated. 

Call your care team if you notice any of these signs or symptoms: 

  • Fever, shaking, chills, dizziness, weakness, or body aches 
  • Pain that does not improve or gets worse, especially pain in the mid-back or side 
  • Nausea or vomiting 
  • Redness, swelling, irritation, or pain around the stoma 
  • Blood in the urine 
  • Trouble urinating (peeing) 
  • Problems with the catheter 

Questions to ask your care team

  • What type of cystectomy do I need?   
  • How do I prepare for surgery? 
  • What type of diversion might I need? 
  • How long will I need to stay in the hospital?  
  • When can I go back to my usual activities? 
  • What are the possible complications after my bladder is removed? 
  • How can I prevent problems from happening? 
  • When and whom should I call if I have concerns? 
  • What tests and medical care should I have after a cystectomy? 

Key points about cystectomy

  • A cystectomy is a surgery to remove part or all of the urinary bladder. 
  • Cystectomy may be done to treat cancer, injury to the bladder, or other medical problems.  
  • After cystectomy, the surgeon makes a new pathway to remove urine from the body (urinary diversion). 
  • Complications after cystectomy may include urine leakage, problems with the stoma, skin irritation, kidney problems, or changes in sexual function.  
  • Follow your care team’s instructions for care after cystectomy and see a urologist regularly.  
  • Seek medical help if you have symptoms such as pain, fever, vomiting, blood in urine, urine leakage, severe skin irritation, or problems with the catheter.  

—
Reviewed: September 2026

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