Radical Cystectomy with Bladder Reconstruction

Radical cystectomy removes the whole bladder and nearby lymph nodes to treat cancer that has grown into the bladder muscle or high-risk cancer that keeps returning. In men the prostate and seminal vesicles are removed too; in women often the womb, and sometimes part of the vagina. A new way for urine to leave the body is then built from a piece of your bowel.

It offers the best chance of cure for muscle-invasive bladder cancer, usually after chemotherapy. It is a long operation with a high rate of complications, and no reconstruction works quite like a natural bladder.

What Radical Cystectomy with Bladder Reconstruction involves

Through an open incision or robotic keyhole ports, the surgeon divides the blood supply to the bladder, frees the ureters and removes the bladder with the surrounding fat and pelvic lymph nodes on both sides. A 15 to 60 cm segment of small bowel is then isolated with its blood supply and the bowel is rejoined. For an ileal conduit a short segment carries urine to a stoma on the abdomen. For a neobladder a longer segment is opened, folded into a sphere and sewn to the urethra so you pass urine the natural way. The ureters are joined to the new system over fine stents, and drains and a catheter are left in place.

Who is a good candidate for Radical Cystectomy with Bladder Reconstruction?

Recommended by a multidisciplinary cancer team after staging scans and biopsy, in people fit enough for major surgery.

• Muscle-invasive bladder cancer without distant spread, ideally after cisplatin-based chemotherapy
• High-grade non-muscle-invasive cancer that has failed BCG treatment
• Reasonable heart, lung and kidney function
• For a neobladder: a cancer-free urethra, good kidney and liver function, and the dexterity to self-catheterise if needed

It is usually not the right choice if:

• Cancer that has already spread widely, where systemic treatment comes first
• People too frail for a 4 to 8 hour operation, who may be offered chemoradiotherapy to keep the bladder
• Neobladder is unsuitable with poor kidney function, bowel disease, prior heavy pelvic radiation or tumour at the bladder outlet
• Anyone unable to stay near the hospital for several weeks after surgery

Technique options

• Ileal conduit (urostomy): Simplest and most common. Urine drains continuously into a bag worn on the abdomen.
• Orthotopic neobladder: A bowel pouch joined to the urethra. No bag, but it needs timed voiding, and night leakage is common.
• Continent catheterisable pouch: An internal reservoir emptied through a small stoma with a catheter several times a day.
• Robotic versus open surgery: Robotic surgery reduces blood loss and may shorten stay; cancer outcomes are similar.
• Bladder-preserving chemoradiotherapy: An alternative for selected tumours after thorough resection through the urethra.

What happens during your treatment

The operation lasts 4 to 8 hours under general anaesthesia, often with an epidural. Expect a night in intensive care or high dependency, then 7 to 14 days on the ward under an enhanced recovery programme with early walking and feeding.

Preparing for your trip

Plan for 4 to 6 weeks in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

Recovery and results

Stents come out at 1 to 3 weeks and a neobladder catheter at about 3 weeks after a dye test. A stoma nurse teaches bag care; with a neobladder you learn to empty by relaxing the pelvic floor and pressing, every 3 to 4 hours, including at night by alarm. Energy and bowel habit take 2 to 3 months to recover. Roughly a quarter of patients are readmitted within 90 days, so distance from the hospital matters.

• Back to everyday activity: 2 to 3 months
• When results show: Pathology result in 1 to 2 weeks guides further treatment
• How long they last: Permanent; lifelong follow-up needed

Safety, risks and revision policy

Even in expert centres more than half of patients have at least one complication in the first three months, most of them manageable.

• Slow return of bowel function (ileus) or bowel obstruction
• Urine leak or narrowing where the ureters join the bowel, which can harm kidney function
• Infection: wound, urinary or pelvic abscess, and sepsis
• Blood clots and significant blood loss
• Erectile dysfunction in men; vaginal shortening and sexual changes in women
• Neobladder: daytime or night-time incontinence, or incomplete emptying needing self-catheterisation
• Stoma problems such as hernia or skin irritation
• Long-term acid-base imbalance and vitamin B12 deficiency

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Radical Cystectomy with Bladder Reconstruction in Türkiye

Clinic-Y does not publish a single price for Radical Cystectomy with Bladder Reconstruction, because the honest figure depends on your case. What moves it:

• Type of urinary diversion chosen
• Robotic or open approach
• Intensive care and total hospital days
• Pathology, stoma supplies and nursing education
• Chemotherapy before surgery, if given in the same centre

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions