Radical Cystectomy in Singapore
Radical cystectomy is a major surgical procedure involving the complete removal of the bladder to treat muscle-invasive or high-risk non-muscle invasive bladder cancer. It often includes reconstruction of a new urinary diversion pathway, such as an ileal conduit or neobladder.
Medically reviewed by Dr Ho Siew Hong
Senior Consultant Urologist
MBBS (NUS), FRCS (Edinburgh, Glasgow), FAMS (Urology), Singapore Board Certified Urologist
This procedure involves removal of the entire bladder, nearby lymph nodes, and surrounding organs if necessary (e.g., prostate in men, uterus in women). Urinary diversion is created using a segment of the intestine to allow urine to exit the body. The reconstructed can either be an ileal conduit which is a stoma over the abdomen or neobladder which to reattached to the urethra to allow normal passage of urine. The surgery can be performed open, or with robotic assistance.
- Muscle-invasive bladder cancer
- High-grade non-muscle invasive cancer unresponsive to BCG
- Recurrent bladder tumours
- Large or aggressive tumours on imaging
- Effective cancer control for advanced or muscle invasive bladder tumours
- Long-term survival benefits in appropriate candidates
- Multiple options for urinary diversion based on lifestyle and preference
- Performed with open or robotic techniques
- General anaesthesia is administered
- Bladder and surrounding tissues are surgically removed
- Lymph node dissection is performed for staging
- A urinary diversion is constructed:
- Ileal conduit (external stoma)
- Orthotopic neobladder (internal pouch)
- Incisions are closed and drainage tubes placed
- Hospital stay of 7–10 days
- Gradual return to soft foods and activity
- Close monitoring for complications and stoma/neobladder function
- Catheter care and wound management instructions provided
- Regular follow-up to assess cancer control and recovery
- Bleeding, infection, or anaesthetic risks
- Bowel or urinary leakage
- Stoma complications or pouch malfunction
- Sexual dysfunction or fertility issues
- Cancer recurrence or lymph node spread
Your Care, Our Priority
Every patient’s condition and goals are unique. Dr Ho Siew Hong will guide you through the safest and most suitable approach for bladder removal and urinary reconstruction.
Frequently Asked Questions
Not always. Options include continent diversion (neobladder) depending on your health and preferences. Most patient prefer neobladder but this complex reconstruction surgery is only suitable for the fitter and younger patients.
Full recovery may take several weeks to months, with ongoing support and follow-up. Immediately following surgery, patients may need ICU care for 1-2 days. Intravenous nutrition support may be needed for patients undergoing neobladder reconstruction.
Yes, most patients can manage the stoma (ileal conduit) on their own after training in hospital. They only need to drain the urine bag when it is full, after several hours. As for neobladder, patients will be taught to manage the pouch at home.
it offers the best chance for cure in muscle-invasive bladder cancer when performed early.
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