Cystectomy and Ileal Conduit

What is a “cystectomy and ileal conduit”?

  • Cystectomy is the complete removal of the bladder
  • In males the prostate is also removed and sometimes the complete urethra as well
  • In females it is sometimes necessary to remove the urethra and the womb and ovaries
  • An ileal conduit is a short segment (20cm) of small intestine. This is isolated from the bowel on its own blood supply and connects and drains the ureters from the back of the abdomen to the skin where a stoma is formed

Why do I need this?

  • This is done when the bladder is diseased or non-functioning
  • The most common disease is bladder cancer. Sometimes benign conditions of inflammation or scarring may lead to removal
  • Poor function such as inability to empty, incontinence or fistula may lead to this procedure

How long does it take?

  • 3-5 hours under a general anaesthetic
  • It is a long operation, especially if time is taken to remove lymph glands at the time of cancer operation
  • Bowel preparation is given pre-operatively

What are the risks?

Early complications can occur in up to 20% of patients

  • These include bleeding requiring transfusion
  • Infections of the wound, the urine or intra-abdominally – antibiotics are given
  • Bowel obstruction or leakage
  • Urinary leakage
  • Stomal problems
  • Blood clots, DVT and pulmonary embolus
  • Chest infection

Late complications can occur even many years later

  • Bowel obstruction
  • Stomal problems, hernias, prolapse, stenosis
  • Kidney problems with obstruction, stones and infections
  • Metabolic problems

What can I expect after surgery?

  • Hospital stay is 7-14 days
  • The anaesthetist will discuss options for pain relief before surgery
  • You will be able to manage the stoma on discharge
  • You should be able to manage personal care and toileting
  • You may need domestic assistance for 4-6 weeks
  • Full recovery takes 6-8 weeks
  • Complications and old age may delay recovery