cystoprostatectomy
Meaning of cystoprostatectomy: Removing the bladder means inventing a replacement for it, and that reconstruction shapes recovery more than the removal does.
Definition of cystoprostatectomy
A cystoprostatectomy is an operation to remove the bladder and the prostate together, performed most often for bladder cancer that has grown into the muscle of the bladder wall. Because the prostate wraps around the outlet of the bladder, the two are taken out as one specimen. A new route for urine has to be built during the same operation.
Why are both organs removed together?
Anatomy leaves little choice. The prostate sits directly beneath the bladder and encircles the tube carrying urine out of it, so the two are continuous rather than neighboring. Cancer arising in the bladder lining can extend down into that stretch of tube and into the prostate itself, and cutting between them would risk leaving disease behind. In the radical version the seminal vesicle on each side is taken as well, along with the lymph nodes in the pelvis, which are where spread appears first and which are examined to judge how far the disease has gone. The same operation is sometimes written from the other end as prostatocystectomy.
Where does urine go afterward?
| Diversion | How it works |
|---|---|
| Ileal conduit | A short length of bowel carries urine to an opening on the abdomen, draining into a bag |
| Continent pouch | A reservoir made from bowel, emptied through a small opening with a catheter |
| Neobladder | A reservoir joined to the urethra, so urine passes by the usual route |
What changes afterward?
Semen is no longer produced, since the prostate and the glands behind it supply nearly all of its volume and the tubes carrying sperm are divided, so orgasm becomes dry and fertility ends. Erections depend on nerve bundles running along each side of the prostate; these can sometimes be preserved, though not when cancer sits close to them. Recovery is measured in months rather than weeks, and the reconstruction usually accounts for more of that time than the removal. In females the equivalent operation for bladder cancer takes the bladder along with the uterus and part of the vaginal wall, and carries a different name.
Also known as
Used in a sentence
A radical cystoprostatectomy with ileal conduit was performed for muscle-invasive disease.
Good to know
The operation ends semen production and fertility because the prostate and seminal vesicles supply most of the fluid, and continence and sexual function afterward depend heavily on which form of urinary diversion was constructed.
Word origin
Where “cystoprostatectomy” comes from
Built from the Greek kystis, a bladder, prostates, one who stands before, and -ektome, a cutting out.