Bladder Removal Complications

Bladder removal surgery is usually performed on patients with later stages of bladder cancer. The bladder is removed to prevent the spread of cancer to surrounding tissues. Bladder removal can change a person's life in intimate ways. A patient should discuss all potential bladder removal complications with his doctor before undergoing surgery.

The Facts

• Bladder removal surgery can be partial or radical. In partial bladder removal, only a part of the bladder is removed. In radical bladder removal in female patients, the whole of the bladder is removed and so are the urethra, uterus, and part of the vagina. In male patients the entire bladder is removed, along with the prostate and seminal vesicles. Complications of bladder removal are often tied to the form of bladder reconstruction or urinary diversion surgery that is performed at the same time.

Neobladder

• A surgeon might be able to create an orthotopic neobladder for a patient by folding over a portion of her bowel to form a pouch that connects to the urethra where her bladder had been. The neobladder gives her some control over urination, but she will experience complications after bladder removal like uncontrolled urine leakage, especially at night. The National Institutes of Health warn that urination will also feel strange or wrong, which can be disconcerting.

Urinary Diversion

• Complications can arise if a surgeon creates a urinary diversion solution after bladder removal. If a patient is given an ileal conduit, then he has a small urine reservoir constructed from a section of his bowel that connects to an opening in the skin. He collects urine from the reservoir in an external appliance. He can experience problems like blood clots, bowel obstruction, breakdown of skin integrity around the skin, and an increased risk of developing pneumonia. He could also experience repeat urinary tract infections. If a patient is given a urinary reservoir, an internal storage pouch for urine that he drains with a catheter, then he can experience the same complications that arise from a ileal conduit. He will also be at an increased risk for ureteral obstruction and ureteral reflux, which can lead to kidney infections.

Fertility Complications

• With radical bladder removal, portions of a patient's reproductive system are removed along with the bladder. This will not only impede a person's sexual function but makes it impossible to have children without the help of fertility specialists. The Rhode Island Cancer Council cautions that a man could become impotent after the procedure. A woman having only partial bladder removal risks complications if she does become pregnant. Pregnancy and childbirth put a strain on the urinary system and can cause damage to a smaller or reconstructed bladder.

Other

• Any patient undergoing bladder removal surgery will risk complications from the surgery itself. He could have an adverse reaction to the anesthesia resulting in a suppressed breathing rate. This could lead to coma or even death. He might experience uncontrolled bleeding during surgery or afterward during the recovery process. He will also be at risk for developing an infection while his incisions heal.