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What are some problems and their solutions after radical cystectomy?



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After a radical cystectomy, the number one question is reconstruction and what kind one might consider. Some patients are better suited to the ileal conduit reconstruction and others may do better with an orthotopic neobladder. In most, but not all radical cystectomies performed for transitional cell carcinoma, a regional lymphadenectomy is performed. If this was not done, you may want to ask if the lymphadenectomy is indicated at a later date. It may not have been done if you underwent the cystectomy for adenocarcinoma of the prostate or other types of cancer.

The second consideration would be ensuring that all surgical margins were clear. When the surgical pathology comes back to your surgeon, you will want to ensure that no residual malignancy remains. If all the cancer was not removed, further surgery or radiation may be warranted.

Lastly, continence and alternatively urinary retention may be issues post-operatively. You will likely leave the hospital with a suprapubic cystostomy, which can become clogged after surgery. With time, this issue will clear up.