Bladder removal, also known as cystectomy, is a major surgery that removes all or part of the bladder. It is most often performed as a treatment for bladder cancer. Naturally, this leads many people to wonder – can you live a long life after bladder removal?
The short answer is yes, it is possible to live a long and healthy life after bladder removal. However, there are many factors that impact life expectancy and quality of life after this surgery. In this article, we will explore the details around bladder removal, life expectancy, and tips for living your best life after bladder removal.
Why is the bladder removed?
There are a few key reasons why someone may need to undergo bladder removal surgery:
– Bladder cancer – This is the most common reason for cystectomy. When bladder cancer is confined to the bladder, removing the entire bladder may eliminate the cancer.
– Severe bladder damage – Certain medical conditions, injuries, or birth defects can severely damage the bladder. In some cases, removing and replacing the bladder with an artificial bladder or pouch is the best option.
– Interstitial cystitis – This chronic bladder condition causes bladder pain and discomfort. Removing the bladder provides permanent pain relief when other treatments have failed.
– Neurogenic bladder – Spinal cord injuries, multiple sclerosis, and other neurological conditions can lead to losing bladder control and function. Cystectomy may improve quality of life in severe cases.
So in most instances, bladder removal is a lifesaving treatment performed when the bladder is dangerously diseased, damaged, or cancerous. It is not usually elective surgery performed for benign conditions.
How is the bladder removed?
There are a few techniques surgeons may use to remove the bladder:
– Radical cystectomy – This removes the entire bladder as well as nearby lymph nodes, part of the urethra, and sometimes the prostate or uterus and surrounding organs. It is the most extensive option but may be necessary to remove all cancerous tissue.
– Simple/partial cystectomy – Only removes part of the bladder, often for small cancerous tumors. Preserves more of the bladder.
– Laparoscopic/robotic surgery – Uses minimally invasive techniques through small incisions instead of one large incision. Can result in less pain and faster recovery.
For bladder cancer patients, radical cystectomy is the most common approach as it is crucial to remove all potentially cancerous tissue. The surgery typically takes between 4-6 hours. Recovery time in the hospital is around 4-7 days.
After the bladder is removed, the surgeon must create a new way to store and pass urine. There are a few options:
Urinary diversion options
– Ileal conduit – Uses a small piece of intestine to create a passageway (stoma) on the abdomen where urine can drain into a bag. This is the simplest and most common diversion after cystectomy.
– Continent diversion – Creates an internal pouch to store urine, where the patient inserts a catheter into the stoma periodically to drain urine. These allow more control but higher risk of complications.
– Neobladder reconstruction – Uses a piece of intestine shaped into a new bladder that attaches to the urethra. This allows urination through the urethra, into a toilet. However, incontinence is still common.
What is the life expectancy after bladder removal?
Life expectancy after bladder removal depends heavily on the reason for cystectomy and how advanced the bladder disease was.
For **bladder cancer patients**, prognosis varies greatly depending on the stage of cancer:
| Bladder cancer stage | 5-year survival rate |
| Stage 0is | 96% |
| Stage I | 88% |
| Stage II | 63% |
| Stage III | 46% |
| Stage IV | 15% |
As you can see, the earlier bladder cancer is caught the better the odds of surviving long-term.
For **non-cancerous bladder conditions** requiring cystectomy, life expectancy is often close to that of the general population if the patient is otherwise healthy. However, lifelong specialized care is crucial.
Some key factors affecting life expectancy after bladder removal include:
– Age at time of surgery
– Overall health status
– Reason for cystectomy
– Cancer stage and progression
– Quality of post-surgical care
– Ability to adjust to lifestyle changes
With proper follow-up care after cystectomy, most patients can enjoy a good quality of life for years to come. Let’s look at how to optimize life after bladder removal.
Coping and recovery after bladder removal surgery
Bladder removal, even when necessary, represents a major change in one’s life. Physical and emotional adjustments will be required. Here are some tips to aid healing and recovery:
**Immediately after surgery:**
– Get plenty of rest. Your body needs to heal.
– Take any prescribed pain medications as directed.
– Walk and move around periodically to prevent blood clots and regain mobility.
– Talk to nurses and doctors about any concerning symptoms like pain or bleeding.
– Begin learning about your new urinary diversion system. A nurse can demonstrate how to properly care for any external bags or stomas.
**During the months after discharge:**
– Attend all follow-up appointments to monitor for recovery complications or cancer recurrence.
– Adhere to any dietary, exercise, or lifestyle recommendations from your healthcare team. This gives your body the best chance to heal.
– Consider physical therapy if needing help rebuilding strength or overcoming mobility challenges.
– Expect emotional ups and downs. Counseling, support groups, or antidepressant medication can help if mood issues persist.
– Reach out to home health aides, visiting nurses, or social workers if extra assistance is needed, even temporarily.
**Long term after cystectomy:**
– Lifelong urologic follow-up is crucial – typically visits every 3-6 months for the first several years, then annually. This allows for checking cancer recurrence, kidney function, and handling any urinary diversion issues.
– Be vigilant about signs of urinary tract infections, which are more common after bladder removal. Seek treatment promptly if symptoms arise.
– Use catheterization techniques properly to avoid infection when required for your urinary diversion type.
– Consider joining a bladder cancer support group to connect with others navigating life after cystectomy.
– Maintain pelvic floor strength through Kegel exercises – reduces incontinence risk.
– Adopt healthy lifestyle habits regarding diet, exercise, sleep, and stress management. This supports overall wellbeing.
While bladder removal surgery and its effects cannot be fully reversed, taking active steps to heal, monitor your health, and care for your new urinary system can help you adapt and even thrive.
Lifestyle adjustments after bladder removal
Bladder removal impacts daily life and routines in many ways both large and small. Being prepared and modifying your lifestyle can smooth the transition:
– **Home preparation** – Remove loose rugs and clutter to avoid falls. Install grab bars in bathrooms. Position items within reach. Plan for single-story living if you cannot safely climb stairs post-surgery.
– **Wardrobe adjustments** – Wear loose, comfortable clothing as your abdomen heals. Bladder cancer patients may opt for patterns or darker colors to conceal ostomy bags beneath clothes.
– **Routine bladder habits** – Remind yourself you no longer have a bladder and cannot “hold it.” Carry extra ostomy supplies when leaving home. Know the location of bathrooms wherever you go.
– **Diet changes** – Your doctor may advise dietary changes to support kidney function or avoid irritating your digestive system if you have an intestinal urinary diversion. Adapt accordingly.
– **Activity and exercise** – While activity is encouraged, avoid heavy lifting, straining, or vigorous exercise during initial healing. Build back activity gradually over several weeks to months.
– **Travel precautions** – When traveling, pack twice the needed ostomy or catheter supplies in case of delays. Keep supplies with you, not packed in luggage that could get lost.
– **Intimacy adjustments** – For sexual activity, extra communication with your partner is key. Certain positions may be more comfortable as you heal. Therapy can help adapt to changes in body image or function.
– **Work adaptations** – Depending on your job duties, a gradual return to work or revised responsibilities may be necessary. Discuss options with your employer.
The extent of lifestyle changes depends on your unique needs. But with creativity and flexibility, most bladder removal patients find a “new normal.” Support from loved ones also eases adjustment.
Outlook and hopes for the future
If you or a loved one is facing bladder removal surgery, it is understandable to feel anxious and uncertain about the future. However, it is important to remember that this operation can add good years to your life in the case of bladder cancer. For other conditions causing severe bladder problems, it can greatly improve your day-to-day quality of life.
Focus on setting small, realistic goals for your recovery. Celebrate milestone achievements. Over time, adaptation to life without a bladder does become easier for most patients.
The future is also bright in terms of new treatments emerging, like:
– Robotic and minimally invasive surgical techniques – Reducing pain, scarring, and healing time.
– Improved ostomy appliances – More discretion and comfort in external urine drainage options.
– Bladder reconstruction innovations – Novel ways to engineer bladder tissue or improve neobladder function.
– Biomarkers and imaging tests – Allowing earlier bladder cancer detection for more preserving treatment.
– Systemic therapies – New immunotherapy drugs boosting survival alone or alongside surgery.
So while bladder removal remains major surgery, the outcomes for patients continue to improve thanks to medical progress.
Stay hopeful – with prudence, patience, care, and support, life after bladder removal can still be abundant. Never hesitate to reach out to medical providers about any ongoing struggles or questions after your cystectomy. They want to help you successfully adjust to this transition.
You are stronger than you know – take it step by step.
Conclusion
Bladder removal surgery is a significant, life-changing procedure. However, with proper post-surgical care and self-care, bladder cancer patients and those with severely damaged bladders can go on to enjoy full, meaningful lives in the years ahead. Medical advancements are also making bladder removal and urinary diversion safer and more effective over time.
While challenges remain, focus on celebrating small recovery milestones, utilizing available support, communicating openly with your healthcare team, and being kind to yourself throughout adjustments. There is hope ahead – many bladder removal patients describe adapting to a “new normal” over time. Patience, willingness to modify your lifestyle as needed, and maintaining follow-up care are all key to your best outcome and longevity.