Name of the Procedure:

Cystectomy, Partial; Simple
Also known as: Partial Cystectomy

Summary

A partial cystectomy involves the surgical removal of a portion of the bladder. This procedure is typically performed when the problem area is confined to a small, localized section of the bladder.

Purpose

Medical Condition:

This procedure is used to address bladder cancer or non-cancerous tumors limited to a specific section of the bladder.

Goals:

• Remove the affected part of the bladder while preserving bladder function.
• Reduce cancer recurrence and improve the patient’s quality of life.

Indications

Symptoms:

• Blood in the urine (hematuria)
• Frequent urinary tract infections
• Pelvic pain or discomfort

Criteria:

• Localized bladder cancer or tumors
• Patients who are not candidates for a full cystectomy
• Adequate bladder function and capacity

Preparation

Pre-procedure Instructions:

• Fast for 8-12 hours before surgery.
• Cease certain medications, including blood thinners, as instructed by the doctor.
• Complete any prescribed preoperative tests, such as blood tests, urine tests, and imaging studies like CT scans or MRIs.

Procedure Description

1. Anesthesia is administered, usually general anesthesia.
2. A small incision is made in the lower abdomen to access the bladder.
3. The surgeon identifies and carefully removes the affected portion of the bladder.
4. The remaining part of the bladder is stitched back together to restore its integrity.
5. A catheter may be placed to help drain urine during the initial recovery period.
6. The incision is closed with sutures or staples.

Tools & Technology:

• Surgical scalpel
• Retractors
• Sutures
• Imaging equipment for guidance

Anesthesia:

General anesthesia is commonly used, ensuring the patient is asleep and pain-free.

Duration

The procedure typically takes 2-4 hours, depending on the complexity.

Setting

Performed in a hospital operating room.

Personnel

• Surgeon (typically a urologist)
• Surgical nurse
• Anesthesiologist
• Surgical assistant

Risks and Complications

Common Risks:

• Bleeding
• Infection at the surgical site

Rare Complications:

• Injury to surrounding organs
• Blood clots
• Urinary leakage or incontinence

Management of complications often involves medical treatment, additional surgical intervention, or specific therapies.

Benefits

• Effective removal of localized bladder tumors
• Preservation of most bladder functions
• Improved quality of life and symptom relief

Realization:

Benefits are usually realized immediately post-recovery, with ongoing monitoring for cancer recurrence.

Recovery

Post-procedure Care:

• Hospital stay of 3-7 days.
• Pain management with medications.
• Instructions to manage the catheter if inserted.

Recovery Time:

• Return to normal activities typically within 4-6 weeks.
• Follow-up appointments for monitoring and potential removal of the catheter.

Alternatives

Other Treatment Options:

• Radical cystectomy (complete bladder removal)
• Transurethral resection (removal of tumors via the urethra)
• Radiation therapy
• Chemotherapy

Pros and Cons:

Radical cystectomy is more extensive but may be necessary for widespread cancer. Transurethral resection is less invasive but may not be suitable for larger tumors.

Patient Experience

During the Procedure:

Patients are under general anesthesia and will not feel pain during the surgery.

After the Procedure:

Patients can expect some pain and discomfort, managed with medications. The presence of a catheter may be uncomfortable initially but is temporary. Frequent follow-up and good post-operative care are crucial for smooth recovery.