Removal of the bladder (cystectomy)

The main treatment for muscle-invasive bladder cancer is surgery to remove the bladder, also known as a cystectomy.

Your doctor may suggest removing your bladder if:

• The cancer has spread into the bladder muscle.
• The cancer is aggressive, has spread to several areas in the bladder, or keeps coming back after treatment.
• Other treatments, like chemotherapy or radiation, haven’t worked, or the cancer has returned.
• You have symptoms like bleeding or pain that can’t be treated in other ways.

Your overall health is important when deciding on treatment and affects how well you recover. Conditions like heart disease, diabetes, or high blood pressure, as well as age, can make healing more difficult. For example, people over 80 often take longer to recover.

Asking questions about bladder removal helps you understand what to expect from the surgery and how it will affect your life. It gives you the information you need to make the best decisions about your treatment. Knowing what will happen before, during, and after the surgery can help you feel more prepared and less anxious. It also gives you the chance talk to your doctor about any worries you might have.

Here are some questions you could ask doctor:

• What are my treatment options?
• Do I need to have my bladder removed, or are there bladder-sparing options?
• If bladder removal is needed, can some organs be spared?
• What are the pros and cons of having my bladder removed?
• How long will the surgery take, and what will the healing process be like?
• How will removing my bladder affect how I go to the bathroom?
• What kind of method will I use to urinate after the surgery, and how does it work?
• What are the possible risks or problems that could happen after the surgery?
• How soon can I go back to my normal activities after the surgery?
• Will I need any more treatments, like chemotherapy or radiation, after the surgery?
• How will this surgery affect my daily life?
• How long will I stay in the hospital after surgery?
• What kind of help or support will I need after the surgery?
• What are the chances the cancer might come back after the surgery?
• Are there other treatment options I should think about before deciding on surgery?

This chapter contains general information about cystectomy. It is not a substitute for professional medical advice or treatment. Always consult your doctor or healthcare provider for guidance on your individual medical situation.

Last updated: November 2025

Reviewed by: 

• Mr. Alex Filicevas (Patient Office EPAG)
• Dr. Laura Mertens (EAU Working Group on Muscle-Invasive and Metastatic Bladder Cancer)