Although in selected patients, treatments to preserve the bladder (such as combined chemotherapy plus radiation and complete TURBT) may be an option, the majority of patients with muscle-invasive bladder cancer will be treated with radical cystectomy – major surgery to remove the diseased bladder and to construct a new urinary diversion. In men, the surgeon will remove the bladder, prostate, seminal vesicles and pelvic lymph nodes, usually a dozen or more. In women, the surgeon may remove not only the bladder, but also the uterus, ovaries, fallopian tubes, cervix, front wall of the vagina and pelvic lymph nodes.
For both men and women, the surgeon may also remove the urethra, depending on which diversion is to be created.
