Radical Cystectomy

Radical cystectomy, the removal of the bladder, is the most effective treatment for muscle invasive bladder cancer. At the University of Chicago Medicine, we are at the forefront of bladder cancer surgery, offering minimally invasive cystectomy and innovative bladder reconstruction that preserves urinary and sexual function. Our team has unrivaled experience, performing more radical cystectomies each month that any other hospital in the Midwest region.

Robotic Radical Cystectomy

Our urologic surgeons are nationally recognized experts in the use of robot-assisted techniques for radical cystectomies. Approximately 30 percent of all the radical cystectomies at UChicago Medicine are performed using minimally invasive methods.

During the procedure, your surgeon is seated at a separate console, where he/she has a three-dimensional view of the abdomen and skillfully maneuvers the robot through removing the bladder and any additional organs or tissue necessary. In some cases, the surrounding lymph nodes are removed as well as the prostate in men and the ovaries, fallopian tubes, uterus and potentially part of the vagina in women. The robotic surgical system provides an increased range of motion and allows for better surgical precision while performing this highly technical procedure.

Minimally invasive bladder surgery offers you numerous advantages, including:

• Less postoperative pain
• Smaller incisions
• Less blood loss
• Less scarring
• Faster recovery and return to normal activities
• Shorter hospital stay (typically between 4-7 days)

Transforming Bladder Reconstruction

UChicago Medicine has led the way in modern bladder reconstruction surgery, performing techniques to maintain continued sexual and urinary function. Our technique builds a new bladder (a neobladder) using about 20 inches of small intestine. The intestine is molded into a sphere that serves as a high capacity, low-pressure urinary reservoir for normal urination and kidney function with no adverse effects on bowel function.

Our surgeons have performed this procedure for more than 25 years in over 800 patients. The entire operation, including removal of the bladder and construction of a new intestinal bladder, takes about four hours. Patients usually remain in the hospital for about a week. With the new bladder, approximately 90 percent of patients will regain normal urinary control and roughly 10 percent may experience mild urinary incontinence.

Along with neobladder reconstruction, we also perform:

• Ileal conduit urinary diversion, which uses a part of your intestine to create a tube that connects your ureters to a pouch (urostomy bag) that is worn outside of your body to collect urine
• Continent cutaneous pouch, which is where an internal pouch is created using a section of your intestine to collect urine. Then, using a catheter through a hole in your abdomen (stoma), you can empty the reservoir throughout the day.

Our urologists continue to make advances in urinary tract reconstruction and are studying ways to use stem cells for bladder reconstruction, leaving the intestine intact.

Nerve Preservation After Treatment

In the past, bladder removal would mean a significant impact to sexual function in men and women. Today, our urologists use nerve preservation techniques whenever possible so our patients can maintain healthy sexual function after surgery. With ongoing advancements in the treatment of bladder cancer, preservation of the nerves adjacent to the bladder and prostate allows 50 to 70 percent of men to regain sexual function. For women, it is now possible to preserve the entire vagina and external genitalia, allowing for normal sexual activity.

Our goal is to eradicate bladder cancer while maintaining as much nerve function as possible to provide our patients with the best quality of life after surgery.