Radical cystectomy procedure: what to know

The operation is performed under anaesthesia. The surgeon removes the bladder and may remove nearby lymph nodes and reproductive organs according to the cancer’s location, anatomy, and agreed plan. A urinary diversion is then made from a segment of bowel or another surgical route. Urine may drain through a stoma into a pouch, or through an internal reservoir connected to the urethra or a catheter.

The approach may be open or minimally invasive. Your surgeon can explain the incision pattern, tubes, drains, and expected hospital care. [Bladder Removal Surgery](/treatments/surgical-oncology/cystectomy/) covers the wider treatment topic.

Bring an accurate medicine list and tell the team about allergies, bowel disease, kidney problems, smoking, and previous operations. Ask for stoma marking and teaching before surgery if a pouch is planned. In hospital, staff monitor urine output, bowel function, pain, wounds, and movement. At home, follow instructions for tubes or appliances, keep follow-up visits, walk as advised, and increase food and activity gradually.

Treatment choices vary. Some people discuss bladder-preserving approaches such as [Intravesical BCG Therapy](/treatments/systemic-therapy/intravesical-bcg-therapy/) when the cancer pattern makes that appropriate.

Call the surgical team for fever, worsening abdominal pain, repeated vomiting, increasing wound redness, leaking urine, or a sudden drop in drainage. Ask for urgent help if the stoma is dark, there is heavy bleeding, you cannot keep fluids down, or you develop severe breathlessness or fainting. A blocked catheter or tube needs prompt advice.

Ask which tissues will be removed, whether lymph nodes will be sampled, which diversion will be created, and how you will empty it. Ask how long tubes may remain, how pain and bowel changes will be managed, when normal activities can resume, and who to contact outside clinic hours.