Radical Cystectomy in Sharjah
Medically reviewed by Dar Al Kamal Team
What is radical cystectomy?
Radical cystectomy is the complete removal of the bladder for cancer. Because bladder cancer that has invaded the muscle can spread to the tissue and lymph nodes around it, the operation also takes the surrounding fat and the pelvic lymph nodes. In men the prostate and seminal vesicles are usually removed with the bladder. In women the operation often includes the womb and part of the front wall of the vagina, and the surgeon discusses which organs can be preserved in your case.
Radical cystectomy is really two operations in one. After the bladder is removed, the surgeon uses a short piece of your own bowel to build a new way for urine to leave the body. This is called a urinary diversion, and choosing it is a decision you make with your urologist before surgery.
| Diversion | How urine leaves the body | What daily life involves |
|---|---|---|
| Ileal conduit | Through a small opening (stoma) on the abdomen into a bag | Emptying and changing a bag; no catheter needed |
| Neobladder | Through the urethra, from a new reservoir made of bowel | Passing urine by timing and gentle abdominal pressure; some people also self-catheterise |
| Continent pouch | Through a small valve on the abdomen | Emptying the pouch with a catheter several times a day; no bag |
At Dar Al Kamal Hospital, Sharjah, radical cystectomy is part of the wider pathway described on the bladder cancer treatment page.
Who needs it
Radical cystectomy is considered for bladder cancer that has grown into the muscle layer of the bladder wall, as shown by a TURBT sample and staging scans. It is also considered for high-risk cancer of the lining that keeps returning despite treatment placed into the bladder, and occasionally for other conditions that have left the bladder severely damaged.
The main alternative for muscle-invasive cancer is bladder-preserving treatment, which combines a thorough TURBT with radiotherapy and chemotherapy. Chemotherapy is also often given before cystectomy to treat any cancer cells elsewhere in the body. The decision weighs the stage of the cancer, your kidney function, your general fitness, your hands and eyesight for stoma or catheter care, and how you feel about each diversion. Your urologist sets out the choices, and the decision is yours to make with that information.
What happens
Radical cystectomy is done under general anaesthesia, through open surgery or by laparoscopy, as your urologist recommends. The surgeon removes the bladder and the planned nearby organs, clears the pelvic lymph nodes, and then builds the chosen diversion from a short segment of small bowel. The ureters, which carry urine down from the kidneys, are stitched into the new conduit or reservoir, often with thin temporary tubes called stents that protect the joins while they heal.
After surgery you are monitored closely. Drains, a drip and the stents are removed step by step as you recover. The team encourages you to sit out, walk and start drinking and eating early, because early movement and eating help the bowel recover. Nurses teach you to care for your stoma, or to flush and empty a neobladder, before you go home.
Preparing for it
If you are having a stoma, a stoma nurse meets you before surgery to mark the best position on your abdomen, checking it while you sit, stand and bend so the bag will sit securely and stay out of your belt line. This meeting is also the place to raise practical questions, including washing, clothing, and managing the bag around prayer and ablution.
A pre-operative assessment checks your heart, lungs, kidneys and nutrition. Improving your fitness with daily walks, eating well and stopping smoking all help recovery from a major operation. Bring your full medicine list, since blood thinners and diabetes medicines need a plan. If surgery is planned close to Ramadan, discuss it early, because fluids and nutrition matter greatly in the weeks after surgery.
Afterwards
Recovery from radical cystectomy is gradual, and your urologist gives you a personal timeline for driving and work. Walk a little more each day, avoid heavy lifting, and keep your wound clean and dry.
Drinking enough is especially important after a urinary diversion. In the Sharjah heat, sweating can concentrate the urine and loosen stoma bag adhesive, so carry water and spare supplies when you go out, and keep supplies stored somewhere cool. Mucus in the urine is normal after a diversion made from bowel. Follow-up at Dar Al Kamal Hospital, Sharjah includes blood tests of kidney function and salts, and scans to check the kidneys and watch for any return of cancer.
Contact the hospital urgently if the urine output drops sharply, the stoma turns dark or very pale, the wound becomes red or leaks, or you develop a fever. **Go to the emergency department straight away for chest pain, sudden breathlessness, a painful swollen calf, repeated vomiting, or severe abdominal pain with swelling.**
Cost and insurance
Most UAE insurance plans cover radical cystectomy as cancer surgery, with pre-approval required, supported by the TURBT histology and staging scans. The hospital stay, pathology, stoma supplies and chemotherapy are often approved separately, and some plans set limits on ongoing stoma or catheter supplies. Dar Al Kamal Hospital, Sharjah can help you check your cover and start the approvals early on 06 599 7777.
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Frequently asked questions
What are the risks of radical cystectomy?
Radical cystectomy is a major operation with risks including bleeding, infection, blood clots, a slow return of bowel function, and leaks from the bowel or ureter joins. Longer-term risks include narrowing where the ureters join the diversion, kidney infections, changes in blood salts, and effects on sexual function. Your urologist explains how these risks apply to you.
Which urinary diversion is best for me?
The best urinary diversion depends on the cancer's position, your kidney and liver function, your bowel health, your dexterity and your preferences. An ileal conduit is the simplest to live with day to day, while a neobladder avoids a bag but needs careful bladder training and sometimes self-catheterisation.
Will I have a bag after radical cystectomy?
You will have a bag on the abdomen after radical cystectomy only if you choose an ileal conduit. A neobladder lets you pass urine through the urethra, and a continent pouch is emptied with a catheter through a small valve, so neither uses an external bag.
Can I pray and fast with a urostomy?
Many people with a urostomy continue to pray, and a stoma nurse can advise on washing and bag changes around ablution. Fasting needs careful planning because a diversion depends on good fluid intake, so discuss Ramadan with your urologist before deciding.
Will radical cystectomy affect my sex life?
Radical cystectomy often affects sexual function. Men usually have difficulty with erections and no ejaculation of fluid, and women may notice vaginal changes. Nerve-sparing or organ-sparing techniques are sometimes possible, and treatments exist to help, so discuss your priorities before surgery.
Is chemotherapy given before radical cystectomy?
Chemotherapy is often recommended before radical cystectomy for muscle-invasive bladder cancer if your kidney function and general health allow. It aims to treat cancer cells that may have spread beyond the bladder, and your urologist discusses it with the oncology team.
Why is there mucus in my urine after a urinary diversion?
Mucus appears in the urine after a urinary diversion because the new conduit or reservoir is made from bowel, and bowel lining naturally produces mucus. Drinking plenty of fluid keeps it thin, and your team will tell you when it needs a check.
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