A cystotomy is a surgical procedure involving the urinary bladder. It entails making an incision directly into the bladder to address various medical conditions. It provides internal access to resolve issues not manageable by less invasive methods.
Defining a Cystotomy
This procedure allows direct access to the bladder’s interior, enabling a surgeon to visualize and manipulate its contents. The primary purpose of this surgical opening is to permit the removal of abnormal tissues, foreign bodies, or obstructions within the bladder. It also facilitates the repair of structural issues or the collection of tissue samples for diagnostic purposes.
Common Reasons for the Procedure
One common reason is the removal of bladder stones, also known as cystic calculi or uroliths, which are mineral formations that can cause irritation, infection, or blockages. These stones can vary in size and composition, and while some may be dissolved with medication, many necessitate surgical extraction. Another frequent indication for a cystotomy is the biopsy or removal of bladder tumors or other abnormal growths.
The procedure is also employed for the removal of foreign objects that may have entered the bladder, causing discomfort or potential damage. Additionally, a cystotomy can be performed to repair injuries to the bladder, such as ruptures resulting from trauma. In some cases, it is utilized to correct structural abnormalities, like the abnormal insertion of ureters, the tubes that carry urine from the kidneys to the bladder. For diagnostic purposes, a cystotomy provides an opportunity to obtain tissue samples for bacterial culture or detailed analysis, particularly in cases of persistent or unexplained bladder inflammation.
What to Expect During and After
Before a cystotomy, individuals typically undergo pre-operative assessments, which may include blood tests and imaging studies like X-rays or ultrasound, to fully evaluate the bladder condition. The surgery is performed under general anesthesia, ensuring comfort and immobility throughout the procedure. A surgeon makes an incision in the lower abdomen, typically along the midline, to access the abdominal cavity and then the bladder. Once the bladder is exposed, an incision is made into its wall, allowing for the intended intervention, such as stone removal or tissue repair. Following the necessary actions, the bladder incision is carefully closed with sutures that dissolve over time, and the abdominal layers are also sutured.
After the cystotomy, a hospital stay of a few days is typical for recovery monitoring. Pain medication will be prescribed to manage post-surgical discomfort, which is expected for one to two weeks. A urinary catheter may be placed during or after surgery to help drain urine and allow the bladder to heal, usually remaining for a few days to a couple of weeks depending on the extent of the surgery. It is common to experience blood-tinged urine, increased frequency of urination, and some straining for several days to two weeks as the bladder inflammation subsides.
Activity will be restricted for at least two weeks to prevent strain on the healing incision; strenuous activities like heavy lifting or vigorous exercise should be avoided. Monitoring the surgical incision for signs of infection, such as excessive redness, swelling, or discharge, is important during recovery. Full recovery can range from two to four weeks, with a return to normal activities often taking four to six weeks. Follow-up appointments are scheduled to monitor healing progress and address any concerns, and if stones were removed, dietary changes might be recommended to prevent recurrence.