For severe bladder diseases not caused by cancer but leading to incontinence, severe bleeding, or pain, removing the bladder can improve quality of life.
Radical cystectomy, the complete removal of the bladder and all affected tissues, is the standard treatment for invasive bladder cancer.



The causes of bladder cancer are not fully understood, but smoking, exposure to certain industrial chemicals (like in paint, textile, and rubber production), chronic bladder inflammation, radiation, genetic predispositions, and parasitic infections in tropical regions are known risk factors.


Typical bladder cancer symptoms include painless blood in the urine and frequent urination, similar to a bladder infection. In advanced stages, weight loss, abdominal pain, and leg swelling can occur.

Special Features

Deeply growing bladder tumors are dangerous and require treatment within three months, usually by radical cystectomy combined with other therapies. This large and complex urological surgery, however, carries numerous complication risks and requires special preparation.
The Da-Vinci cystectomy is a robot-assisted, minimally invasive keyhole surgery requiring special surgical expertise. Instruments are introduced under general anesthesia through small abdominal incisions and then controlled by the surgeon via a console.

How is the surgery performed?

During the surgery, the bladder and the affected surrounding tissue are removed, and, if oncologically possible, the vascular nerve bundles are preserved to maintain sexuality.
After bladder removal, an alternative pathway for urine is needed. For this, an appropriate section of the small intestine is isolated from the intestinal tract while preserving its blood supply (blood vessels), and its continuity is restored.

How are the urinary tracts reorganized?

In the case of a neobladder:

A neobladder (replacement bladder) is created from a section of the small intestine where urine is collected and expelled naturally, just like in the original bladder.

In the case of an ileal conduit/urostomy:

The ureters are connected to a piece of the small intestine and led through the abdominal wall to collect urine in a bag attached to the abdomen.
The success of the entire operation depends on the team’s experience and specific patient data.

What risks should be considered?

General surgical risks:

Every surgery carries certain risks, such as bleeding during or after the operation, damage to adjacent organs, or wound healing problems.

Patient-specific risks:

Previous surgeries, illnesses, or medications can affect the course of the operation and postoperative recovery. These risks are assessed individually based on the patient’s medical history.

Surgery-specific risks:

Possible consequences include erectile dysfunction in men and impaired intercourse in women, as well as urinary incontinence and metabolic disorders in a replacement bladder. The removal of the lymph nodes can lead to an accumulation of lymph fluid (lymphocele). Also, intestinal complications such as obstruction, leaks, and delayed activity, which may require further interventions, are possible.
Depending on the tissue analysis, a tailored treatment and follow-up plan will be developed. Additional therapy may be necessary. Surgery can often cure tumors, but regular check-ups remain essential as cancer can recur. Moreover, a balanced diet, adequate fluid intake, exercise, and sleep support recovery and strengthen long-term health.

What happens after the surgery?







4-6 hours
7-10 days
3 weeks (for replacement bladder)
Initially spinal anesthesia, then oral painkillers
no dressings, the stitches are self-dissolving

Benefits of Dr. Sarychev's Surgery

Low complication rate
of patients experience no significant complications, average in literature 44-58%
Low blood loss
Niedrige Komplikationsrate
97,3 %
of patients do not require blood transfusions, which is an important indicator of survival
Low blood loss
Niedrige Komplikationsrate
of patients regain night and daytime urinary continence after bladder replacement

Low blood loss
Low blood loss
of patients, depending on their age, regain their erectile function after nerve-sparing surgery
Geringer Blutverlust