Radical cystectomy: what to know

Because the bladder stores urine, surgery must include urinary diversion. Depending on your anatomy, health, and surgeon’s recommendation, urine may drain through a stoma into an external pouch or pass through an internal reservoir connected to the urethra or a catheter. The operation may also include removal of nearby lymph nodes and, where relevant, nearby reproductive organs.

The choice is personal and affects body image, toileting routines, sexual function, and daily activities. A specialist nurse can show you equipment and explain how each option works. [Bladder Removal Surgery](/treatments/surgical-oncology/cystectomy/) gives further background.

Before surgery, review medicines, smoking, nutrition, exercise, and any kidney or bowel problems with the team. Learn how to empty or care for the urinary diversion and arrange support at home. Early recovery includes walking, breathing exercises, wound care, and gradual return to food and activity. Bowel changes, tiredness, altered urination, and emotional adjustment can take time.

Your team may discuss other bladder cancer treatments, including [Intravesical BCG Therapy](/treatments/systemic-therapy/intravesical-bcg-therapy/), when appropriate. The recommendation depends on tumour features and whether cancer has entered the bladder muscle.

After surgery, contact the team for fever, increasing wound redness or drainage, persistent vomiting, worsening abdominal pain, very little urine, cloudy or foul-smelling urine, or a stoma that changes colour. Emergency care is needed for severe breathlessness, fainting, heavy bleeding, or sudden confusion. Do not wait for a routine appointment if a tube stops draining.

Ask why radical cystectomy is recommended, what urinary diversion suits you, which organs or lymph nodes may be removed, and what changes to sexual or bowel function are possible. Ask when you can drive, work, exercise, and bathe, who will teach stoma care, and which symptoms require urgent review.