Partial Cystectomy
What is a Partial Cystectomy?
A partial cystectomy is a surgical procedure in which only the diseased portion of the bladder is removed while preserving the remaining healthy bladder. Unlike a radical cystectomy, which removes the entire bladder, a partial cystectomy allows many patients to continue passing urine normally through their natural urinary tract.
The procedure is performed in carefully selected patients, most commonly for certain types of bladder cancer that are confined to a single area of the bladder. It may also be used to treat selected non-cancerous conditions affecting the bladder wall. Because only part of the bladder is removed, preserving normal bladder function is one of the main advantages of this operation.
What are the Benefits of a Partial Cystectomy?
For appropriately selected patients, a partial cystectomy offers several important benefits.
Benefits include:
- Preserves much of the natural bladder
- Maintains normal urination in most patients
- Removes localised bladder disease while conserving healthy tissue
- Avoids the need for urinary diversion in many cases
- Can provide effective cancer treatment for selected tumours
- May be performed using open, laparoscopic, or robotic-assisted techniques
- Shorter recovery compared with more extensive bladder removal in suitable patients
- Preserves quality of life for appropriately selected individuals
When is a Partial Cystectomy Recommended?
A partial cystectomy is only suitable for carefully selected patients after thorough assessment.
It may be recommended for:
- A single, localised muscle-invasive bladder tumour
- Selected bladder cancers located away from the bladder neck and ureteric openings
- Tumours arising within a bladder diverticulum
- Certain rare non-cancerous bladder conditions
- Localised bladder abnormalities requiring surgical removal
Most bladder cancers are not suitable for partial cystectomy because they often involve multiple areas of the bladder or have a high risk of recurrence elsewhere. Your urologist will determine whether bladder preservation is appropriate based on imaging, cystoscopy findings, biopsy results, and tumour characteristics.
What does Preparation for a Partial Cystectomy Involve?
Before surgery, you will undergo a comprehensive evaluation to determine whether partial cystectomy is the most appropriate treatment.
Preparation may include:
- Medical history and physical examination
- Blood and urine tests
- CT scan or MRI of the urinary tract
- Flexible or rigid cystoscopy
- Bladder biopsy or transurethral resection (TURBT)
- Review of current medications, including blood-thinning medicines
- Assessment of your fitness for anaesthesia
- Discussion of the operation, recovery, and possible alternatives
Your surgeon will explain whether additional treatments, such as chemotherapy before or after surgery, may be recommended depending on the underlying diagnosis.
How is a Partial Cystectomy Performed?
A partial cystectomy is performed under general anaesthetic and may be carried out using an open, laparoscopic, or robotic-assisted approach, depending on the location of the tumour and the surgeon's recommendation.
During the operation, the surgeon carefully identifies the affected area of the bladder and removes the tumour together with a margin of healthy surrounding tissue to help ensure complete removal. In many cases, nearby lymph nodes are also removed for pathological examination, particularly when treating bladder cancer.
Once the diseased section has been removed, the remaining bladder is reconstructed by carefully closing the bladder wall with absorbable sutures. The bladder is then tested to ensure it is watertight before the operation is completed.
A urinary catheter is left in place to allow the bladder to heal, and in some cases a temporary surgical drain may also be inserted. The procedure usually takes between two and four hours, depending on its complexity.
What to Expect during Recovery after a Partial Cystectomy?
Most patients remain in hospital for several days following surgery.
During recovery, you can expect:
- A urinary catheter for approximately one to two weeks
- Mild to moderate discomfort controlled with pain medication
- Gradual return to eating and walking
- Temporary blood in the urine
- Fatigue during the early recovery period
- Follow-up imaging or a bladder X-ray before catheter removal in some cases
Once the catheter has been removed, most patients gradually return to normal bladder function, although urinary frequency may be increased initially while the bladder heals.
Regular follow-up cystoscopies and imaging are essential after partial cystectomy, particularly for bladder cancer, as new tumours can develop elsewhere in the remaining bladder.
What are the Risks and Complications of a Partial Cystectomy?
Partial cystectomy is a well-established surgical procedure, but all major operations carry potential risks.
Possible complications include:
- Bleeding
- Infection
- Blood clots in the legs or lungs
- Leakage from the bladder repair
- Injury to nearby organs
- Temporary urinary leakage
- Reduced bladder capacity leading to increased urinary frequency
- Recurrence of bladder cancer within the remaining bladder
- Need for additional surgery or further cancer treatment
- Anaesthetic-related complications
Your urologist will explain whether a partial cystectomy is suitable for your condition, discuss the expected benefits and risks, and develop an individualised treatment and follow-up plan to achieve the best possible outcome.