A radical cystecomy may be needed for more advanced cancers. A radical cystectomy involves removing the tumor, the entire bladder, and surrounding lymph nodes. In men, the prostate gland is also removed. In women, the ovaries, fallopian tubes, the uterus, and a small portion of the vagina are often also removed
along with the bladder. Cystectomy may provide a cure for some types of bladder cancer, but some may need additional therapies such as chemotherapy.
Since the bladder is removed, there is no way to store or eliminate urine from the body. A urinary diversion will be created to allow the urine to leave the body. Options include:
Conduit diversion—The ureter will be connected to a section of the small intestine so that the urine can drain into the intestine. The intestine is then connected to an opening in the abdominal walled called the stoma. Waste including urine can pass through this opening into a collection bag outside of the body.
Continent diversion—The ureters are connected to a pouch made from the small and large intestines. The intestine is then connected to an opening in the abdominal walled called the stoma. Waste including urine can pass through this opening into a collection bag outside of the body.
Neo-bladder—This method preserves as much bladder function as possible. A pouch is created using intestinal tissue. Both the ureters and urethra are connected to this pouch so that urine can pass out of the body as it normally would. A catheter may be needed to help the urine pass out of the body. This type of urinary diversion can also be done if the cancer is blocking urine flow and a cystectomy is not an option.