cystectomy


Also found in: Dictionary, Encyclopedia, Wikipedia.
Related to cystectomy: myomectomy, Partial cystectomy, Radical cystectomy

Cystectomy

 

Definition

Cystectomy is a surgical procedure to remove the bladder.

Purpose

Cystectomy is performed to treat cancer of the bladder. Radiation and chemotherapy are also used to treat bladder cancer. Surgery is used to remove cancer when it is in the muscle of the bladder.

Precautions

Cystectomy is an aggressive treatment that may not be appropriate for patients with superficial tumors that respond to more conservative treatment.

Description

Cystectomy is a major surgical operation. The patient is placed under general anesthesia. An incision is made across the lower abdomen. The ureters are located, tied and cut. The ureters connect the kidneys to the bladder. Cutting them frees the bladder for removal. The bladder and associated organs are removed. In men the prostate is removed with the bladder. In women, the uterus, fallopian tubes, ovaries, and part of the vagina are removed with the bladder. The bladder collects urine from the kidneys for excretion at a later time. Since the bladder is removed, a new method must be created to remove the urine. A small piece of the small intestine is removed, cleaned, and tied at one end to form a tube. The other end is used to form a stoma, an opening through the abdominal wall to the outside. The ureters are then connected to the tube. Urine produced by the kidneys now flows down the ureters, into the tube, and through the stoma. The patient wears a bag to collect the urine.

Preparation

The medical team will discuss the procedure and tell the patient where the stoma will appear and what it will look like. The patient receives instruction on caring for a stoma and bag. Counseling may be initiated. A period of fasting and an enema may be required.

Aftercare

After the operation, the patient is given fluidbased nutrition until the intestines being to function normally again. Antibiotics are given to prevent infection of the incision sites. The nature of the organs removed mean that there will be major lifestyle changes for the person undergoing the operation. Men will become impotent because nerves controlling penile erection are cut during removal of the bladder. In women, infertility is a consequence because the ovaries and uterus are removed. However, most women who undergo cystectomy are postmenopausal and past their childbearing years.
Both men and women are fitted with an external bag that connects to the stoma and collects the urine. The bag is generally worn around the waist under the clothing. It takes a period of adjustment to get used to wearing the bag. Because there is no bladder, urine is excreted as it is produced, essentially continuously. The stoma must be treated properly to ensure that it does not become infected or blocked. Patients must be trained to care for their stoma. Often there is a period of psychological adjustment to the major change in life style created by the stoma and bag. Patients should be prepared for this by discussion with their physician.

Risks

As with any major surgery, there is a risk of infection; in this case infection of the intestine is especially dangerous as it can lead to peritonitis (inflammation of the membrane lining the abdomen).

Key terms

Ureters — Tubes that connect the kidneys to the bladder. Urine produced by the kidneys passes through the ureters to the bladder.

Normal results

The bladder is successfully removed and a stoma created. Intestinal function returns to normal and the patient learns proper care of the stoma and bag. He or she adjusts to lifestyle changes and returns to a normal routine of work and recreation, some sports excluded.

Abnormal results

The patient develops an infection at the incision site. The patient does not make a successful psychological adjustment to the long term consequences of impotence and urinary diversion. In some women, the vagina is constricted, which may require a secondary procedure.

Resources

Books

Berkow, Robert, editor. Merck Manual of Medical Information. Whitehouse Station, NJ: Merck Research Laboratories, 2004.

cystectomy

 [sis-tek´to-me]
1. excision of a cyst.
2. excision or resection of the urinary bladder.

cys·tec·to·my

(sis-tek'tō-mē),
1. Excision of the urinary bladder.
2. Excision of the gallbladder (cholecystectomy).
3. Removal of a cyst.
[cyst- + G. ektomē, excision]

cystectomy

/cys·tec·to·my/ (sis-tek´tah-me)
1. excision of a cyst.
2. excision or resection of the bladder.

cystectomy

(sĭ-stĕk′tə-mē)
n. pl. cystecto·mies
1. Surgical removal of a cyst.
2.
a. Surgical removal of the gallbladder.
b. Surgical removal of all or part of the urinary bladder.

cystectomy

[sistek′təmē]
Etymology: Gk, kystis + ektomē, excision
a surgical procedure in which all or part of the urinary bladder is removed, as may be required in treating bladder cancer.

cystectomy

Surgery
1. Excision of the bladder. See Radical cystectomy.
2. Excision of a cyst.

cys·tec·to·my

(sis-tek'tŏ-mē)
1. Excision of the the urinary bladder.
2. Excision of the gallbladder (cholecystectomy).
3. Removal of a cyst.
[cyst- + G. ektomē, excision]

cystectomy

Surgical removal of the urinary bladder, usually for cancer. After cystectomy, the ureters, which carry urine down from the kidneys, have to be implanted into the colon or into an artificial bladder made from an isolated length of bowel which drains out through the skin.

cystectomy

1. excision of a cyst.
2. excision or resection of the urinary bladder.
References in periodicals archive ?
All patients undergoing radical cystectomy with PLND for clinical cTis-T4aN0-1M0 urothelial carcinoma of the bladder between June 2011 and June 2013 were invited to participate in this study.
Usual operation for laparoscopic ovarian cystectomy was done using stripping the cyst wall by normal saline hydrodissection.
Conclusion: We found that oncological outcomes of radical cystectomy performed with the indication of bladder tumor were comparable between young and elderly We believe that age perse should not constitute a contraindication for radical cystectomy operations.
6) Inspired by the treatment algorithms for pulmonary SmCC, combined chemotherapy, radiotherapy, and transurethral resection regimens have been developed as a bladder-sparing alternative to cystectomy.
Lingual thyroglossal duct cyst with recurrence after cystectomy or marsupialization under endoscopy: Diagnosis and modified Sistrunk surgery.
Usually, following a cystectomy, the urine will have to find another way to get out of the body and would be stored in a pouch outside the body which can be manually emptied.
This second edition contains new material on procedures such as hand-assisted laparoscopic radical cystectomy, and incorporates new techniques of robot-assisted surgery.
A partial cystectomy was performed and the histologic diagnosis was extra-adrenal paraganglioma (pheochromocytoma).
Conservative surgical techniques such as marsupialisation, total cystectomy, and partial pericystectomy with omentoplasty
When radical cystectomy is not performed within 12 weeks of diagnosis with stage II bladder cancer, all-cause and disease-specific mortality increases, US researchers report.
Radical cystectomy and lymphadenectomy is a standard treatment for patients with high-grade, invasive bladder cancer.