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Walk to End Bladder Cancer

Bladder Removal Surgery For Bladder Cancer

Bladder removal surgery, called a cystectomy, removes part or all of the bladder to treat bladder cancer. A radical cystectomy removes the entire bladder and may be recommended for muscle-invasive bladder cancer or certain high-risk non-muscle invasive bladder cancers. After the bladder is removed, surgeons create a urinary diversion so urine can leave the body. 

What you need to know

  • Bladder removal surgery is called cystectomy.  
  • A radical cystectomy removes the entire bladder.  
  • A partial cystectomy removes only part of the bladder and is appropriate only in selected situations.  
  • Radical cystectomy may be used for muscle-invasive bladder cancer and certain high-risk non-muscle invasive bladder cancers.  
  • After radical cystectomy, a urinary diversion creates a new way for urine to leave the body.  
  • Recovery from bladder removal surgery takes time, and people can learn to manage their urinary diversion and return to many everyday activities. 

What is a radical cystectomy?

A cystectomy is surgery to remove part or all of the bladder. A radical cystectomy removes the entire bladder and is a treatment for certain types of bladder cancer. A partial cystectomy removes only the part of the bladder containing the tumor and is used much less often. 

During a radical cystectomy, the surgeon also removes nearby lymph nodes. Depending on the cancer and the individual patient, nearby reproductive organs or other tissues may also be removed. 

A urologist may recommend bladder removal surgery when bladder cancer has grown into the bladder muscle or when certain high-risk non-muscle invasive bladder cancers persist or return after treatment. Whether a cystectomy is appropriate depends on the cancer’s stage and grade, previous treatments, overall health and other individual factors. 

  • Cancer that persists or returns after treatments such as BCG  
  • Other situations in which removing the bladder may help control the cancer  

What happens before bladder removal surgery? 

Before bladder removal surgery, your healthcare team will perform tests to find out the extent of the cancer and whether it has spread beyond the bladder. These may include CT scans, MRI or other imaging. The results help your medical team decide whether surgery is appropriate and whether other treatments should be given before or instead of surgery. 

Watch: What is a cystectomy?

This short video explains what a cystectomy is and how bladder removal surgery is used to treat bladder cancer.

How do you urinate after bladder removal surgery? 

When the entire bladder is removed, the surgeon creates a urinary diversion so urine can continue to leave the body. The main types include an ileal conduit, neobladder and continent cutaneous pouch, sometimes called an Indiana pouch. Each works differently, and the right option depends on factors such as your health, anatomy and individual needs. 

Learn about urinary diversion options after bladder removal surgery. 

What are the risks of a radical cystectomy?

A radical cystectomy is major surgery, and there can be complications during or after the procedure.  Individual risk depends on factors including overall health, age, surgical approach and type of urinary diversion. Your healthcare team can explain your individual risks and the steps taken to reduce them. 

A few of the biggest risks include: 

  • infection 
  • bleeding 
  • urinary tract or kidney problems  
  • complications from the urinary diversion 

BCAN also provides detailed information about complications and concerns during cystectomy recovery.

Are there alternatives to bladder removal surgery? 

Some people with bladder cancer may have alternatives to radical cystectomy depending on the type, stage and location of the cancer, previous treatments and overall health. Learn more about bladder preservation therapy. 

What is recovery like after bladder removal surgery? 

Recovery after bladder removal surgery varies from person to person and can take several weeks to several months. Recovery includes healing from major surgery and learning how to manage a urinary diversion. Your healthcare team will provide guidance about activities such as lifting, driving, working and exercise. 

Can you live an active life after bladder removal surgery? 

Many people return to active, fulfilling lives after bladder removal surgery. Adjusting to a urinary diversion and new routines takes time, but people can return to work, travel, exercise, hobbies and social activities. Experiences vary, and support from healthcare professionals, caregivers and other people who have had bladder removal surgery can help during the adjustment. 

Read Salley’s story about her radical cystectomy. 

Frequently asked questions about bladder removal surgery

How long does it take to recover from bladder removal surgery? 

Recovery can take several weeks to several months and varies depending on the surgery, urinary diversion, overall health and whether complications occur. Your healthcare team will provide individualized guidance about returning to work, driving, exercise and other activities. 

How do you urinate without a bladder? 

After a radical cystectomy, a surgeon creates a urinary diversion so urine can leave the body. The main types are an ileal conduit, neobladder and continent cutaneous pouch (Indiana pouch). Learn more about urinary diversion options. 

What should I ask my doctor before a radical cystectomy? 

Ask why surgery is being recommended, whether other treatment options are appropriate, which urinary diversions may be options for you, what complications to expect, how surgery may affect sexual function, and what recovery and follow-up care may involve. 

Does everyone with bladder cancer need bladder removal surgery? 

No. Treatment depends on the type and stage of bladder cancer, previous treatments, overall health and other individual factors. Radical cystectomy is one treatment option and is not appropriate for everyone. 

Videos and resources about bladder removal surgery 

The New Normal: Living with a Urinary Diversion 
Hear from bladder cancer survivors about living with different urinary diversions. 

Bladder removal surgery webinar 
Learn more about cystectomy from Divya Ajay, MD. 

Download: What Is a Radical Cystectomy? 
BCAN’s two-page patient fact sheet. 

Life After Bladder Removal Surgery Video Series

Four-part series covering adjustment, lifestyle, caregiver considerations and psychosocial issues.

Information and services provided by the Bladder Cancer Advocacy Network (BCAN) are for informational purposes only. The information and services are not intended to be substitutes for professional medical advice, diagnosis or treatment. If you are ill, or suspect that you are ill, seek professional medical attention immediately! BCAN does not recommend or endorse any specific physicians, treatments, procedures or products even though they may be mentioned on this site.

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