Bladder Surgery

What is bladder surgery?

Bladder surgery is a procedure on your urinary bladder. Your urinary bladder holds your urine (pee) after your kidneys clean your blood.

There are many different types of bladder surgery. The type of surgery you may need depends on which condition is affecting your bladder.

What does bladder surgery treat?

Conditions that may require bladder surgery include:

• Bladder cancer.
• Fallen bladder/bladder prolapse (cystocele).
• Loss of bladder control (urinary incontinence).

What are the different types of bladder surgery?

There are many different types of bladder surgery. Some common types of bladder surgery include:

• Cystectomy. This procedure removes part of (partial cystectomy) or all of (radical cystectomy) your bladder, usually to treat bladder cancer.
• Transurethral resection of bladder tumor (TURBT). A surgeon uses a long, thin tool with a camera at one end (cystoscope) to locate and cut out (resect) a bladder tumor.
• Urinary reconstruction and diversion. This is a surgery to make a new way for your body to store and pass pee.
• Retropubic suspension. This is a type of bladder lift surgery that treats a sagging bladder by moving your bladder and urethra back to their usual positions.

How common is bladder surgery?

It’s common. Bladder cancer is the most common reason for people to undergo bladder surgery. There are many different types of bladder surgery to treat bladder cancer. Each year, tens of thousands of people receive a bladder cancer diagnosis.

How should I prepare for bladder surgery?

You’ll meet with a healthcare provider before bladder surgery, where they’ll:

• Review your health history.
• Perform a physical examination to make sure you’re healthy enough to have surgery.
• Take your vitals (temperature, pulse and blood pressure).
• Conduct a blood test and pee test (urinalysis) to rule out infection.

Tell your provider about any prescription or over-the-counter (OTC) medications you’re taking, including herbal supplements. They may recommend that you stop taking any medications that increase your risk of bleeding during your bladder surgery, including:

• Aspirin.
• Nonsteroidal anti-inflammatory drugs (NSAIDs).
• Blood thinners (anticoagulants).
• Certain herbal supplements.

Don’t stop taking any medications unless the provider tells you.

Tell the provider about all your allergies, as well. These include:

• Drug allergies.
• Skin cleaner allergies, like iodine or isopropyl alcohol.
• Latex allergy.
• Food allergies.

A provider may also ask you to stop smoking and using tobacco products. Tobacco use increases health risks during and after surgery, including slowing down the healing process and decreasing your immune system’s effectiveness.

You’ll likely receive specific directions on eating and drinking before bladder surgery. This may include following a clear liquid eating pattern eight to 12 hours before your surgery. Clear liquids include juices without pulp, soup broth and gelatin (Jell-O®).

What kind of surgeon performs bladder surgery?

Urologists perform bladder surgeries. Urologists specialize in treating conditions affecting the urinary system and the male and female reproductive systems.

Is bladder surgery inpatient or outpatient?

It depends on the type of surgery you need. Outpatient means you can go home the same day as your surgery. Inpatient means you need to spend at least a day in the hospital. Ask a healthcare provider if you’ll need to stay in the hospital and, if so, for how long. You may need to stay in the hospital for up to a week.

What happens during bladder surgery?

There are two different approaches to bladder surgery:

• Minimally invasive surgery (robotic surgery). Robotic surgery is the most common surgical approach to bladder surgery. A surgeon will make a small number of incisions and then place implanted ports in the incisions that allow them to use robotic arms to perform the procedure. Robotic surgery reduces healing time, scarring and other risk factors.
• Open surgery. A surgeon will use a sharp knife (scalpel) to make one long cut (incision) in your abdomen (belly) to access your bladder. They’ll insert their hands through the incision to perform the procedure. Open surgery is rare.
• Endoscopic surgery. A surgeon will use a long camera (endoscope) through your urethra to access to your bladder. There are no incisions with this surgery.

When you talk to a healthcare provider about bladder surgery, feel free to ask lots of questions. Make sure you understand and feel comfortable with what the provider explains to you.

Will I be asleep during the bladder surgery?

Yes. An anesthesiologist will give you general anesthesia before surgery. General anesthesia puts you to sleep. You won’t feel pain or experience any other sensations during bladder surgery.

How long does bladder surgery take?

It depends on the procedure. Some procedures may take up to six hours or longer. Talk to a healthcare provider to better understand what to expect.

What happens after bladder surgery?

Healthcare providers will stitch your incisions and cover them with bandages. You’ll also stop receiving anesthesia. After a few minutes, you’ll be conscious (awake) but will likely feel groggy.

Providers will continue to monitor your health. Once you wake up fully, they’ll treat your pain.

You may have side effects after surgery, including:

• Urinary frequency.
• Urinary urgency.
• Blood in your pee (hematuria).

Healthcare providers will talk to you about what to expect after surgery.

What are the benefits of bladder surgery?

The main benefit of bladder surgery is that it treats bladder cancer or another condition that affects your bladder or other parts of your urinary system. In some cases, it’s the only way to treat these conditions.

Is bladder surgery high-risk?

All surgeries come with risks, including:

• Anesthesia risks.
• Bacterial infection.
• Internal damage.
• Blood clots.
• Scarring.

Bladder surgery can be a major surgery with a significant risk of other complications. You have a higher risk if you’re older than 60 or female. Possible complications include:

• Gastrointestinal problems that can affect your ability to poop.
• Reproductive health problems, especially if your treatment also involves removing your prostate or uterus to treat bladder cancer that spreads.
• Hormonal changes, especially if a surgeon must remove your ovaries to treat bladder cancer that spreads.
• Urinary problems, including leaking or an inability to pee without using a urinary catheter.

In rare cases, severe bladder surgery complications may be fatal.

How long does it take to recover from bladder surgery?

It depends on the bladder surgery procedure. In general, most people need at least a few weeks to recover. But it may be a month or two before you regain your strength. A healthcare provider will give an estimate of your recovery time, including when you can return to work or school.

Which medications will I need to take?

A healthcare provider will likely prescribe prescription or over-the-counter pain relievers. Ask about any other medications before you go home.

Will I have to limit my activity?

Yes. Don’t exercise or lift objects that are heavier than 8 pounds (about the weight of a gallon of water) for at least a few weeks after bladder surgery.

What can I eat and drink after bladder surgery?

Be sure to get plenty of fluids. You’ll have an increased risk of developing a urinary tract infection (UTI) if you don’t get enough water.

It’s also a good idea to eat lots of nutritious foods that promote healing, including:

• Fresh and dried fruits.
• Vegetables.
• Beans and legumes.
• Lean meats.

When should I call a healthcare provider?

Contact a healthcare provider if you have any of the following symptoms after bladder surgery:

• Severe pain, especially when you’re peeing (dysuria).
• You can’t pee.
• Blood in your pee.
• Signs of infection, including a fever, chills or discoloration (red, purple, brown or black) or pus around your incisions.
• Heavy bleeding around your incisions.

Can you live without your bladder?

Yes, you can live without your bladder. If a healthcare provider removes your bladder, you’ll need a urostomy or neobladder surgery.

Can you live a normal life without a bladder?

It’s normal to worry about how bladder removal surgery may affect your quality of life, especially as you adjust to a potentially new way for pee to leave your body. But with some extra planning, many people can still enjoy their usual activities, including physical activity and travel.

What replaces a bladder when it is removed?

If a urologist removes your bladder, they’ll perform reconstructive bladder surgery to create a new way for your body to store and remove pee. The different methods include:

• Continent cutaneous diversion. A surgeon will make a new pouch out of part of your intestines to store pee. They’ll also create a surgical opening (stoma) in your abdomen. You’ll occasionally empty the pouch with a suprapubic catheter that you insert into your stoma.
• Ileal conduit. The surgeon will disconnect a small section of your small intestine, attach it to one end of your ureters (tubes that carry pee from your kidneys to your bladder) and attach the other end of your ureter to a stoma. Your pee collects in a plastic bag (ostomy bag) that you place over your stoma.
• Neobladder. The surgeon makes a new bladder (neobladder) out of your small intestine to store and remove pee. The neobladder exists in the same location in your body as your original bladder, and your pee exits your body through your urethra.

How do you pee after bladder removal surgery?

It depends on what type of reconstructive surgery you have after bladder removal surgery. You may have to use a catheter to drain pee out of your body through a stoma. If you have a neobladder, pee comes out of your body the same way that it would with your original, healthy bladder.