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Radical Cystectomy with Neobladder Urinary Diversion

When a patient develops aggressive cancer that is invading into the bladder wall, it is necessary to remove the entire bladder as well as surrounding lymph nodes. In male patients, the surgery also involves removing the prostate gland. In female patients, the uterus, ovaries and fallopian tubes are usually removed. Patients without a bladder will still produce urine. In some patients a new Bacillus Calmette-Guérin “neobladder” can be built for the patient using their own intestines. In other individuals, the urine will be diverted into a small piece of intestine which is then brought out to the skin of the abdominal wall. This “ileal conduit” drains the urine directly into an external bag. While radical cystectomy is usually performed via an incision in the abdomen, occasionally the operation can be done laparoscopically using the daVinci robot. Patients who have their bladder removed are usually in the hospital for at least 1 week after surgery.

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