For muscle-invasive bladder cancer, complete removal of the bladder remains the most effective treatment. Robotic radical cystectomy combines the curative intent of this major operation with the advantages of minimally invasive surgery with smaller incisions, reduced blood loss, and a faster recovery. It is major surgery, and our team supports you through a structured recovery programme before and after the operation.
TREATMENTS
Robotic Radical Cystectomy
When May Cystectomy Be Recommended?
Radical cystectomy is a significant procedure. It is recommended when:
• Cancer has invaded the muscle wall of the bladder (muscle-invasive bladder cancer, MIBC)
• High-grade, non-muscle-invasive bladder cancer has not responded to intravesical treatments such as BCG
• Bladder cancer is at very high risk of progression despite intravesical treatments
• There is extensive or diffuse high-grade disease not amenable to bladder preservation
• Severe urinary symptoms from cancer, or from cancer treatment, have caused significant deterioration in quality of life
Where appropriate, chemotherapy or immunotherapy before surgery (neoadjuvant treatment) improves outcomes and is considered for every eligible patient.
Urinary Reconstruction Options
• Ileal conduit (urostomy): A segment of bowel is used to divert urine to an external bag (stoma) on the abdominal wall. The most commonly performed reconstruction.
• Orthotopic neobladder: A new bladder-like reservoir is fashioned from bowel and connected to the urethra, allowing you to pass urine naturally. However, all will need to use self-catheterisation, at least in the short term.
• Continent urinary diversion: An internal reservoir that is emptied with a catheter through a small opening in the abdomen, avoiding an external bag while retaining continence. Used in selected cases only.
Risks and Considerations
All procedures carry risks, which your surgeon will discuss with you in detail. These may include:
• Slow return of bowel function (ileus) — the most common early issue
• Infection, blood clots, and the general risks of major surgery; re-operation is uncommon but possible
• Changes to sexual function
• Stoma or diversion-related adjustments including ureteric stricture
• Lifelong follow-up of kidney function, vitamin B12 and cancer surveillance
Recovery at a glance: Typically 5–10 nights in hospital, no heavy lifting for 6 weeks, slow return of energy levels over 6–12 weeks.
1
Pre-Operative Planning
CT and MRI staging, assessment of urinary reconstruction options, and stoma education (where applicable). Chemotherapy or immunotherapy before surgery is considered for all eligible patients. Prehabilitation with exercise and nutrition recommendations with smoking cessation begins as soon as surgery is planned.
2
Bladder Removal
The bladder, surrounding fat, and pelvic lymph nodes are removed robotically through small incisions. In men, the prostate and seminal vesicles are removed; in women, the uterus and part of the vaginal wall may also be removed.
3
Urinary Reconstruction
The chosen form of urinary diversion is fashioned, usually from a segment of small bowel, and the urinary tract is reconstructed during the same operation.
4
Outcome Monitoring
Pathology results guide further treatment decisions. Kidney function, cancer control, and quality of life are all assessed at regular follow-up.
Our Approach
