A person may need surgery for bladder cancer to remove the tumor. A person may also need preoperative or postoperative treatments.

Bladder cancer occurs when cells of the bladder start to grow out of control. Doctors use three surgical procedures to treat this cancer: transurethral resection with fulguration, partial cystectomy, and radical cystectomy with urinary diversion.

Read on to learn more about the types of bladder cancer surgery and what each one involves. This article also looks at when a person might need bladder cancer surgery, how to prepare for surgery, and more.

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Surgery is the main treatment for bladder cancer.

A doctor may recommend one of three possible procedures to remove bladder cancer.

Transurethral resection with fulguration

Transurethral resection with fulguration involves inserting a small tube called a cystoscope through the urethra and into the bladder.

The surgeon uses a slender instrument with a wire loop on the end to cut or burn the tumor with high energy electricity. This is known as fulguration.

Partial cystectomy

A partial cystectomy is a more invasive surgical procedure that involves removing the tumor and a portion of the bladder.

Since some of the bladder remains, a person can maintain their usual bladder function. However, they may not be able to hold as much urine and therefore may need to urinate more frequently.

Radical cystectomy

The most invasive form of bladder cancer surgery, radical cystectomy involves the complete removal of the bladder, the tumor, and surrounding tissues such as:

  • the prostate
  • the seminal vesicles
  • the uterus
  • the ovaries
  • part of the vagina

Learn more about bladder removal surgery.

Reconstructive surgery

If a person undergoes a radical cystectomy, the surgeon will need to create a new way for the person to pass urine out of their body.

Diversion involves using a short portion of the small intestine to create either an ileal conduit or an internal pouch and then connecting the new urine reservoir to a stoma, which is an opening in the abdomen.

An ileal conduit is a passageway that allows urine to flow freely without intervention into a bag attached to the abdomen. A stoma requires the person to use a drainage tube to empty the pouch throughout the day.

A surgeon may be able to create a new bladder, or neobladder, from a portion of the small intestine. With this option, a person will retain the urinary function they had before the surgery.

Bladder cancer surgery is the main treatment option for bladder cancer. A doctor will likely recommend surgical removal of the cancer after diagnosis.

The type of surgery that may work best for a person can depend on several factors, including:

  • overall health
  • tumor size
  • cancer stage
  • personal preferences

A doctor can advise on the type of surgery that is most appropriate and answer any questions a person may have.

A treatment team or surgical team will help a person prepare for bladder cancer surgery. Preparation may involve:

  • testing to check the person’s overall health and vitals
  • meeting with the surgeon or other members of the surgical team to discuss the procedure
  • taking steps to prepare the bowels to reduce the amount of stool in them

Before the procedure, a person will likely need to take antibiotics to help reduce the risk of infection. The surgical team will likely advise a person to stop eating about 6 hours before the procedure and stop drinking 2 hours beforehand.

A person should expect to stay in the hospital for 1–2 weeks after the procedure. This time will vary based on how a person recovers and other factors, such as insurance coverage. A person should make plans that can accommodate a longer stay, which may include:

  • arranging care for children, pets, or plants
  • scheduling time off from work
  • canceling or rescheduling any other activities

Preoperative therapy

In some cases, a doctor may use chemotherapy as a preoperative therapy (neoadjuvant therapy) to shrink the tumor before surgery. They may also recommend postoperative therapy (adjuvant therapy) to destroy any remaining cancer cells. These therapies may include:

A person’s doctor can provide more information about any treatments they recommend before the surgery.

A person will need time to recover in the hospital, often 1–2 weeks. During this time, a care team will monitor a person’s recovery and provide any special instructions about returning home.

If the surgeon created a stoma, a person’s recovery will involve learning how to care for the stoma and dispose of urine.

A person will also likely need additional cancer treatment. These therapies will help destroy any cancer cells that may remain after the tumor’s removal.

Bladder cancer surgery poses the same risks as many other forms of surgery, including:

  • infection
  • blood clots in the lungs or legs
  • negative reaction to anesthesia
  • damage to local organs or tissue
  • bleeding

The surgeon can provide information about steps that can help reduce these risks.

A doctor may recommend that a person receive additional treatment before or after surgery.

Before surgery, a doctor may recommend chemotherapy to shrink the tumor. This makes surgical removal possible.

After surgery, doctors may recommend treatments to kill any remaining cancer cells. These may include:

  • immunotherapy
  • targeted therapy
  • chemotherapy
  • radiation

Learn more about bladder cancer treatments.

The following sections provide answers to frequently asked questions about bladder cancer surgery.

How serious is bladder cancer surgery?

Bladder cancer surgery ranges from a relatively noninvasive procedure to remove a small tumor to the full removal of the bladder. A person’s overall health, the stage of cancer, and the person’s preferences can influence which procedure a surgeon uses.

What is the most common surgery for bladder cancer?

The most common surgery for bladder cancer is a minimally invasive transurethral resection of a bladder tumor. It involves inserting a small tube and tool into the bladder and cutting away the tumor.

What is the survival rate after bladder cancer surgery?

Survival rates vary depending on the location, size, and stage of the cancer. According to the National Cancer Institute, the estimated 5-year survival rates for bladder cancer are:

  • 97% in cases in which cancer has not spread beyond the bladder lining
  • 71% in cases of localized bladder cancer
  • 39% in cases of regional bladder cancer that has spread to nearby lymph nodes or organs
  • 8% in cases of metastatic bladder cancer

The survival rate represents the proportion of people who are still alive for a length of time after receiving a particular diagnosis. For example, a 5-year survival rate of 50% means that 50%, or half, of the people are still alive 5 years after receiving the diagnosis.

It is important to remember that these figures are estimates and are based on the results of previous studies or treatments. A person can consult a healthcare professional about how their condition is going to affect them.

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At what stage of bladder cancer is the bladder removed?

A doctor will likely recommend a total bladder removal if the cancer has spread to the muscle layers or if the cancer involves a large part of the bladder.

Bladder cancer surgery ranges from minimally invasive to full removal of the bladder and restructuring of the urinary passage. A person may need preoperative treatment to help shrink the tumor or postoperative treatment to help destroy any remaining cancer cells.

A person should follow all instructions from a surgeon before the procedure. They may need to stay in the hospital for a week or two after surgery and may have changes in urine elimination after total removal of the bladder.