For cancers that have invaded into the muscular layer of the bladder wall or for more severe cancers that have extended over much of the bladder and those which have failed to respond to more conservative treatments: surgery is necessary. In this operation, the entire bladder as well as its surrounding lymph nodes and other structures that are infected are removed. The bladder is removed sometimes to relieve of severe urinary symptoms. This is called radical cystectomy.
Occasionally, part of the bladder that is infected will have to be removed this is called partial cystectomy. This is used for low grade tumors that are limited to a certain portion of the bladder only.
In men, during cystectomy, the prostate and seminal vesicles are also removed. This may affect your sexual function as the production of semen is stopped. In women, the uterus, ovaries, and part of the vagina will have to be removed. The process of menstruation is stopped permanently, and you can no longer become pregnant. The operation may also cause sexual and urinary problems.
Once the bladder has been removed, it calls for an alternate pathway to pass out the urine. This process is called urinary diversion. Removal of the bladder is complicated because it requires creation of a new pathway for urine to leave the body. This is called urinary diversion. In majority of the cases, a combination of chemotherapy and radiation therapy may help to preserve the bladder. But the therapy is highly toxic and the patient might have to get his bladder removed in later stages. After the cystectomy, the patients also receive chemotherapy as an added measure to kill any microscopic cancer cells remaining and increase the chance of cure. It is imperative he patient has thorough knowledge about the surgical procedure and its side effects.