Bladder Cancer

Surgery

Mayo Clinic surgeons have extensive experience and training in all types of bladder cancer surgery. The most appropriate surgery is based on the cancer's developmental stage and your personal preference.

Removal During Cystoscopy

For small or early stage bladder cancer that hasn't penetrated the bladder wall, your doctor may recommend minimally invasive surgery, typically performed during cystoscopy. A narrow tube (cystoscope) is inserted through the urethra (the channel that carries urine from the bladder and out of the body). The cystoscope's optical system allows doctors to see inside the bladder and insert and manipulate instruments through the tube to perform surgery. Surgeons remove the cancer using thermal ablation (closely focused high heat), or using a high-energy laser, or by simply cutting tissue away.

Partial Cystectomy

If the cancer has progressed too far to be easily removed during a cystoscopy, surgeons may remove both the tumor and a small segment of the bladder in a procedure known as partial cystectomy (also occasionally referred to as segmental cystectomy). Partial cystectomy is appropriate when the procedure is unlikely to harm bladder function.

Following tumor removal, patients return for regular cystoscope examinations to monitor any cancer recurrence or complications. During these follow-up exams, your doctor may also use the cystoscope to remove a tissue sample (biopsy) for laboratory analysis.

Mayo Clinic surgeons also perform partial cystectomies using robotic surgery. Robotic surgery is performed through a series of small incisions, often called "key hole" incisions. The surgeon sits at a console away from the operating table and, using handheld controls, manipulates the surgical instruments of the robotic system to perform the intricate operation. Another member of the surgical team, positioned at the operating table, changes and manipulates the instruments as needed and monitors the patient. Robotic surgery can result in less bleeding and pain, as well as quicker recovery following surgery.

Radical Cystectomy

More advanced cancer requires removing the entire bladder (radical cystectomy), a common procedure in advanced bladder cancer cases. As with partial cystectomy, surgeons can perform radical cystectomy either by traditional surgery through an abdominal incision, or by robotic surgery. Mayo Clinic draws on its vast experience performing radical cystectomies to maximize your long-term health and quality of life. Radical cystectomy is generally performed more often than partial cystectomy, depending on how invasive/advanced the cancer has become.

Bladder Reconstruction Surgery

Many patients who undergo radical cystectomy at Mayo Clinic are good candidates for bladder and urinary tract reconstruction, more commonly referred to as neobladder surgery or neobladder reconstruction surgery.

In neobladder reconstruction, surgeons first remove the cancerous bladder, and then fashion a new bladder from a section of the patient's small intestine. They then place the neobladder in the same location as the original bladder, so the kidneys drain into it and urine can be voided normally from the neobladder via the urethra. Read more about neobladder surgery at Mayo Clinic.