Removal of the bladder is preformed for confirmed cases of bladder cancer. According to MayoClinic.com, the extent of bladder removal depends on how advanced the cancer is. A bladder tumor that has invaded the wall of the urinary bladder will require the most aggressive treatment: complete removal of the bladder, known as radical cystectomy. Along with the bladder, the lymph nodes are also removed. Some pelvic organs are also removed in males and females with advanced disease. Because of the extensive nature of this operation, it is associated with many complications.
Urinary Incontinence
When the urinary bladder is removed, the surgeon has to come up with alternate ways for urine drainage, referred to as urinary diversion. Not all procedures preformed guarantee future continence for the patient. Traditionally, the surgeon converted a loop of intestine into a tube carrying the urine outside the body through an abdominal wall opening to a collecting bag that the patient emptied regularly. Other alternative, newer, procedures available involve constructing an internal reservoir from the intestine that is either emptied by a catheter the patient inserts through an opening in the abdomen, or through the urethra in some instances where the manufactured reservoir can be reattached to a portion of the remaining urethra.
Infertility
MayoClinic.com stresses the fact that infertility results from a total bladder removal, if the procedure is a radical cystectomy. This is because in males, radical cystectomy involves removal of the seminal vesicles and prostate, the factory houses of semen. In females, bladder removal surgery may entail removal of the ovaries and part of the uterus. These pelvic organs need to be removed in advanced tumors because they lie in close proximity to the urinary bladder and may be involved with the tumor.
Sexual Dysfunction
An article published in "European Urology Supplements" in April 2010 notes that like all extensive pelvic operations involving tumor removal, sexual dysfunction in both males and females is a common side effect. In males, this is most likely due to nerve damage which causes erectile impairment. Females who have had bladder removal surgery may suffer from painful intercourse which affects their sexual desire. In fact, the study in the European Association of Urology reports that only half of females resume their sexual life after they have had bladder removal.
