In a partial cystectomy, the surgeon makes a midline low or transverse incision from the umbilicus to the symphysis pubis. He
then opens the bladder and removes the tumor along with a small portion of healthy tissue. To complete the procedure, he closes the wound, leaving a Penrose drain and suprapubic catheter in place.

In a simple cystectomy, the surgeon first makes a midline abdominal incision. He then removes the entire bladder, leaving only a portion of the urethra.

In a radical cystectomy, the surgeon also removes, in addition to the bladder, the seminal vesicles and prostate in male patients and the uterus, ovaries, fallopian tubes, and anterior vagina in female patients. Depending on the extent of the cancer, the surgeon may also remove the urethra and surrounding lymph nodes.

To complete either a simple or radical cystectomy, the surgeon provides for urinary diversion by attaching the ureters to an external collection device, such as a cutaneous ureterostomy, conduit of large or small bowel, or continent urinary neobladder.

Immediately after surgery, potential complications include bleeding, hypotension, and nerve injury (such as to the genitofemoral or peroneal nerve). Later complications include anuria, stoma stenosis, urinary tract infection, pouch leakage, electrolyte imbalance, stenosis of the ureteroileal junction, and vascular compromise. Radical and simple cystectomy may also cause psychological problems relating to changes in the patient’s body image and loss of sexual or reproductive function.

Impaired urinary elimination related to removal of bladder. Based on this nursing diagnosis, you’ll establish these patient outcomes. The patient will:

Risk for infection related to manipulation of bowel and instrumentation in the abdominal cavity. Based on this nursing diagnosis, you’ll establish these patient outcomes. The patient will: