Partial cystectomy
Surgery that removes the part of the bladder holding a tumor, with a rim of healthy wall, and then sews the bladder closed. It keeps your own bladder and is used for urachal cancer and a few carefully chosen single tumors.
Also called partial cystectomy, segmental cystectomy, partial bladder removal, remove part of the bladder, bladder-sparing surgery, urachal cancer surgery, urachal tumor removal, en bloc urachal excision
- Where
- Hospital operating room
- Anesthesia
- General anesthesia
- Time in the room
- 2 to 4 hours, longer with lymph node removal
- Hospital stay
- 1 to 3 days after robotic surgery; 3 to 5 days after open surgery
- Going home with
- A urinary catheter for about 7 to 14 days; sometimes a drain for 1 to 2 days
- Back to normal
- 4 to 6 weeks
- Back to work
- 2 to 3 weeks for desk work; about 6 weeks for heavy work
Overview
A partial cystectomy removes only the part of the bladder that contains the tumor. The surgeon cuts through the full thickness of the bladder wall with a margin of healthy tissue all around, along with the fat just outside it. The rest of the bladder is sewn closed. You keep your own bladder and urinate normally afterward.
It suits only a small number of bladder cancers. The tumor must be single, in a spot that allows a clean cut with healthy margins, most often the top of the bladder (the dome), and away from the ureter openings and the bladder outlet. There must be no carcinoma in situ (CIS) elsewhere in the bladder, and enough bladder must remain to hold a useful amount of urine.
It is the standard surgery for urachal cancer, a rare cancer that starts in the urachus. The urachus is a leftover cord from before birth that runs from the top of the bladder to the belly button. For urachal cancer, the surgeon removes the bladder dome, the urachus and the belly button in one piece, usually with the pelvic lymph nodes.
Because the rest of the bladder lining stays, new tumors can grow there later, so lifelong cystoscopy checkups are needed. For muscle-invasive cancer starting in the bladder lining, chemotherapy before surgery is usually recommended, as it would be before a full cystectomy.
The parts of your body involved
The bladder is a muscular bag that sits low in the pelvis. Its top, called the dome, is the part that rises as the bladder fills. Low in the bladder is the trigone, the triangle where the two ureters bring in urine from the kidneys, just above the bladder outlet. The wall has a thin lining, a connective layer, a thick muscle layer, and fat outside. From the dome, a thin cord called the urachus runs up the inside of the belly wall to the belly button.
- Dome
The top of the bladder, far from the ureter openings. Tumors here are the easiest to remove with a margin.
- Bladder wall
Lining, connective layer, muscle and fat. A partial cystectomy removes all of these layers around the tumor.
- Trigone and ureter openings
Kept intact whenever possible. Tumors close to them are usually not suitable for partial cystectomy.
- Urachus
A leftover cord from the bladder to the belly button. Cancer can rarely start here.
- Belly button
Removed together with the urachus for urachal cancer, and rebuilt or closed afterward.
- Pelvic lymph nodes
Small glands along the pelvic blood vessels, removed to check for spread.
Why it’s done
Partial cystectomy is chosen when a tumor can be removed completely with healthy tissue around it, and the rest of the bladder is healthy. It removes the cancer while keeping normal urination and avoiding a urinary diversion.
- Urachal cancer
Removing the dome, urachus and belly button in one piece is the standard treatment for urachal cancer that has not spread.
- A single tumor at the dome
For a single muscle-invasive tumor in a favorable spot, with no CIS elsewhere and a good-sized bladder, partial cystectomy can control the cancer in selected people.
- A tumor in a diverticulum
A diverticulum is a pouch where the bladder lining pushes out through the muscle. Its wall is thin, so a TURBT can be unsafe or incomplete, and removing the whole pouch is often better.
- Other tumors involving the bladder
Some non-bladder tumors, or cancers of nearby organs such as the colon, grow into a small part of the bladder and can be removed with a piece of bladder wall.
- Avoiding a bigger operation
For some people at high risk from a full cystectomy, a partial cystectomy may be a safer way to remove a suitable tumor.
Other options
- Radical cystectomy
Removing the whole bladder and nearby lymph nodes, with a urinary diversion. It is the standard surgery for most muscle-invasive bladder cancers.
- Bladder-sparing chemoradiation
For selected muscle-invasive cancers, a thorough TURBT followed by radiation with chemotherapy can keep the bladder, with lifelong cystoscopy.
- TURBT
For tumors that have not grown into the muscle, removal through the urethra is the standard treatment and no cut is needed.
- Drug treatment
Chemotherapy, immunotherapy and newer drug combinations are used before surgery, after surgery, or alone when cancer has spread.
Getting ready
Tick items off as you go. Your checklist is saved on this device only.
Weeks before
The week before
The day before
The morning of surgery
In the operating room, step by step
Press play or pick a step. Each drawing shows what your surgeon is doing at that moment. Your team may do some steps differently.
1. Anesthesia and a look inside
You are given general anesthesia. With your legs in stirrups, your surgeon first looks inside the bladder with a cystoscope to see the tumor again and check the rest of the lining.
The surgeon sits at a console a few steps from you and moves every instrument with hand controls and foot pedals. The robot cannot move on its own or make decisions.
A camera on one arm gives the surgeon a bright, three-dimensional picture magnified about ten times, which helps them see small nerves and vessels.
The instruments are about the width of a pencil and bend like a wrist inside your body, so the surgeon can stitch and dissect through small openings.
A bedside assistant and a scrub nurse stay at the table, and the anesthesia team watches your breathing and blood pressure throughout. Most U.S. hospitals use the da Vinci system made by Intuitive.
After the operation
In the hospital
- Waking up
You wake with a catheter and possibly a drain. Bladder spasms, sudden cramping and an urge to urinate, are common and can be eased with medicine.
- Moving early
Walking starts the evening of surgery or the next morning, several times a day.
- Eating
Because the bowel is not cut, most people can eat lightly the day of or the day after surgery.
- Pain control
Acetaminophen, anti-inflammatory medicine when safe, and a small amount of opioid if needed. Shoulder aching from the gas is common after robotic surgery.
- Preventing blood clots
Leg squeeze sleeves and blood thinner shots. Some people continue the shots at home, especially after lymph node removal for cancer.
- Drain removal
If a drain was placed, it usually comes out before you leave, once fluid output is low.
- Going home
Usually 1 to 3 days after robotic surgery and 3 to 5 days after open surgery, with the catheter in place.
At home
- Catheter care
Keep the bag below your bladder. Use a leg bag by day and a larger bag at night. Clean where the catheter enters your body with soap and water daily.
- Catheter removal
The catheter usually comes out in the clinic about 7 to 14 days after surgery. Some surgeons first do an X-ray with dye in the bladder (cystogram) to make sure it has healed.
- After the catheter is out
Expect to urinate often and urgently at first, because the bladder is smaller. It stretches over weeks to months, and most people get back close to their old pattern.
- Blood and spasms
Pink urine and bladder spasms are common for 1 to 2 weeks. Drink extra fluids, and use the spasm medicine if you were given one.
- Fluids
Drink about 8 to 10 cups a day unless told otherwise.
- Bowels
Avoid straining. Use a stool softener while on pain medicine.
- Lifting and activity
Walk every day. Avoid lifting more than about 10 pounds for 4 to 6 weeks.
- Driving
Usually after 1 to 2 weeks, once off opioid pain medicine and able to brake hard without pain. Many people prefer to wait until the catheter is out.
- Showering
Showers are fine after 24 to 48 hours. Avoid baths and swimming until the incisions are healed and the catheter is out.
- Sex
Usually after about 4 to 6 weeks, once the catheter is out and you feel comfortable.
Recovery timeline
- Day 0Surgery
You wake with a catheter and possibly a drain.
- Days 1 to 3Home
Most people go home after robotic surgery within 1 to 3 days, with the catheter.
- Weeks 1 to 2Pathology and catheter out
Your team reviews the pathology, including margins and lymph nodes. The catheter is removed, sometimes after an X-ray.
- Weeks 2 to 6The bladder stretches
Frequent urination and urgency gradually ease. Energy returns.
- About 3 monthsFirst checkup
Cystoscopy and often a scan look for any new tumor or spread.
- First 2 yearsClose follow-up
Cystoscopy about every 3 months and scans every 3 to 6 months, depending on the cancer.
- Long termLifelong checks
Checkups continue for life, spacing out over time, because new tumors can form in the remaining bladder.
What it feels like
Many people feel lucky to keep their bladder, and recovery is shorter than after a full cystectomy. The catheter weeks and the frequent urination that follows are the hardest physical parts. The emotional part is often the ongoing checkups.
Hearing you can keep your bladder
Relief, sometimes mixed with worry about whether leaving the rest of the bladder is safe.
What helpsAsk your surgeon why you are a good candidate and what the plan is if cancer comes back. Careful selection is what makes this operation safe.
Waking up
A catheter, a sore belly and strong bladder spasms that feel like an urgent need to urinate.
What helpsAsk for spasm medicine. Spasms ease as the bladder heals.
Living with the catheter
Embarrassment and discomfort at the tip of the urethra, especially when walking or sitting.
What helpsA leg bag under loose pants, securing the tube to your thigh, and lubricating gel at the tip help.
The catheter comes out
Relief, then surprise at how often you need to go, sometimes every hour or so at first.
What helpsThis is expected while the smaller bladder stretches. It improves week by week.
Waiting for results
Worry while the pathology on the margins and lymph nodes is pending.
What helpsAsk before surgery when and how you will get the results.
Before each cystoscopy
A wave of worry before every checkup, sometimes for years.
What helpsThis is common. Small new tumors found early are usually easy to treat.
How well it works
A successful partial cystectomy removes the tumor with clear margins, finds no cancer in the lymph nodes, and leaves a bladder that works well. Lifelong checkups watch for new tumors.
- Clear margins
Healthy tissue around the tumor on all sides means it was removed completely.
- Lymph nodes
Cancer in the lymph nodes may lead to more treatment, such as chemotherapy or immunotherapy.
- Bladder function
Most people's bladder stretches back to a useful size over several months, with near-normal urination.
- New tumors
New tumors can grow in the remaining bladder, and some people later need a TURBT, other treatment, or a full cystectomy. Regular cystoscopy finds them early.
- Follow-up
Cystoscopy about every 3 months at first, plus periodic scans, spacing out over time if all stays clear.
Risks
Every operation has risks. These are the ones people ask about most, with honest odds where good numbers exist. Your surgeon’s own results matter more than averages.
Common
Common while the catheter is in and for a week or two after.
Expected after the catheter comes out, while the smaller bladder stretches.
Treated with antibiotics.
Less common
Usually heals by keeping the catheter in longer.
Prevented with walking, leg sleeves and blood thinner shots.
A pocket of fluid where lymph nodes were removed. Most go away; some need drainage.
New tumors can form elsewhere in the bladder or near the scar. Found early on cystoscopy and treated.
More likely after open surgery or at the belly button site after urachal surgery.
Rare
Usually recognized and repaired during surgery.
Bladder cancer cells can grow in the belly or wound if spilled. Careful technique makes this rare.
If a large part of the bladder is removed, it may stay small and cause frequent urination long term.
As with any major surgery, more likely in people with existing heart or lung disease.
Call your care team or go to the emergency room if
- Fever of 101°F (38.3°C) or higher, or shaking chills.
- Your catheter stops draining for more than 1 hour, even after you check for kinks, or your lower belly feels full and painful.
- Urine that looks like ketchup or has thick clots.
- Belly pain or swelling that is getting worse, especially with nausea or vomiting.
- Clear or yellow fluid leaking from an incision, or redness, swelling or pus.
- After the catheter is out, you cannot urinate for 4 hours or more.
- Pain or swelling in one leg, or sudden chest pain or shortness of breath: call 911.
Questions to ask your surgeon
- Why am I a good candidate for a partial cystectomy instead of a full cystectomy?
- Were biopsies done to rule out CIS elsewhere in my bladder?
- Do I need chemotherapy before surgery?
- Will you do my surgery robotically or open?
- How much of my bladder will be removed, and how much will I be able to hold afterward?
- Will you remove my lymph nodes, and for urachal cancer, my belly button?
- How long will the catheter stay in?
- What happens if the margins are not clear?
- How often will I need cystoscopy and scans?
- What would we do if cancer comes back in my bladder?
Words you may hear
- Pneumoperitoneum
- The gas-filled belly that makes keyhole surgery possible. Carbon dioxide is pumped in through a thin needle or the first port until the belly wall lifts like a tent (usually at a pressure of 12 to 15 mmHg), giving the camera and instruments room to work. The gas is let out at the end, and the little that remains is absorbed and breathed out over a day or two; it can cause shoulder-tip ache in the meantime.
- Partial cystectomy
- Removing part of the bladder wall with a tumor and closing the rest.
- Dome
- The top of the bladder.
- Urachus
- A leftover cord from before birth that runs from the top of the bladder to the belly button.
- Urachal cancer
- A rare cancer, usually an adenocarcinoma, that starts in the urachus.
- Margin
- The rim of healthy tissue removed around a tumor. Clear margins mean no cancer at the edge.
- Carcinoma in situ (CIS)
- Flat, high-grade cancer cells on the bladder lining. Its presence usually rules out a partial cystectomy.
- Diverticulum
- A pouch where the bladder lining pushes out through a weak spot in the muscle.
- Lymph node dissection
- Removing lymph nodes to check for and remove cancer spread.
- Cystogram
- An X-ray with dye in the bladder to check for leaks.
- Bladder spasm
- A sudden cramp of the bladder muscle that feels like an urgent need to urinate.
- Frozen section
- A quick check of tissue by the pathologist during surgery.
Common questions
Why can't everyone with bladder cancer have this?
Most bladder cancers are in places that cannot be removed with a safe margin, or the bladder lining has other areas of cancer such as CIS. In those cases, removing part of the bladder would likely leave cancer behind.
Will I urinate normally afterward?
Yes. You may go more often at first, but the bladder stretches over the following months, and most people get close to their usual pattern.
Can cancer come back?
Yes. New tumors can form in the remaining bladder, which is why lifelong cystoscopy is needed. Many can be treated by TURBT; some people later need a full cystectomy.
Will I have a scar?
With robotic surgery, several small scars. With open surgery, one lower belly scar. After urachal surgery, the belly button is usually removed and the area closed or rebuilt.
Is urachal cancer the same as bladder cancer?
It grows in the bladder dome but starts from a different tissue, so it behaves differently and is treated differently. Surgery is the main treatment.
Sources this page draws on
- American Urological Association, ASCO, ASTRO and Society of Urologic Oncology, Treatment of Non-Metastatic Muscle-Invasive Bladder Cancer: AUA/ASCO/ASTRO/SUO Guideline
- European Association of Urology, EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer
- Mayo Clinic, Urachal carcinoma: clinicopathologic features and long-term outcomes (Ashley and colleagues, Cancer) (2006)
- American Cancer Society, Bladder Cancer Surgery
- National Cancer Institute, Bladder Cancer
Written November 2026. This page explains what usually happens. It is not medical advice and does not replace a conversation with your own surgeon, whose plan for you comes first.