Uro-oncology · United Kingdom
Cystectomy — bladder removal, done by a uro-oncology team that does a lot of them.
A clinically reviewed patient guide to cystectomy — why it is done, the approach (open, laparoscopic or robotic), the choice of urinary diversion, and what recovery actually looks like.
Why patients choose us
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A consultant uro-oncology surgeon, in theatre
Not a general urologist and not a trainee. A named uro-oncology specialist with a high-volume cystectomy practice and a proper theatre team.
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Robotic cystectomy team where it fits
Robotic-assisted radical cystectomy (RARC) — with intracorporeal urinary diversion where the case allows — offered alongside open surgery when that is the safer choice.
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Independent, and free
We are paid by no hospital, so the recommendation on surgeon, approach and diversion type (ileal conduit, neobladder, continent pouch) is impartial and costs you nothing.
Indicative pricing
What a private cystectomy costs in the UK.
Indicative ranges across our partner hospitals. Send the details and we quote firm figures across two or three options — surgeon, approach, and diversion type.
In short
Robotic radical cystectomy with an ileal conduit in our network: £28,000–£45,000, home in 5–10 nights.
| Procedure | Indicative range | Typical duration | Hospital stay |
|---|---|---|---|
| Robotic radical cystectomy + ileal conduit | £28,000–£45,000 | 5–7 hours | 5–10 nights |
| Robotic radical cystectomy + orthotopic neobladder | £32,000–£55,000 | 6–8 hours | 7–12 nights |
| Open radical cystectomy + ileal conduit | £24,000–£38,000 | 4–6 hours | 7–12 nights |
| Partial cystectomy (selected cases) | £15,000–£25,000 | 2–4 hours | 3–6 nights |
| Neoadjuvant chemotherapy cycle | £3,000–£6,000 | Day case | Per cycle |
| Uro-oncology consultation only | £250–£450 | 45 min | Same visit |
Prices vary by hospital, by surgeon, by whether the case is open or robotic, and by the diversion chosen (ileal conduit, neobladder, or continent pouch). Neoadjuvant chemotherapy, ITU stay, extended stay and adjuvant therapy sit outside the surgical fee. We come back with a firm quote within one working day.
The problem
The right surgeon, the right approach, the right diversion.
Cystectomy outcomes vary enormously by surgeon volume, MDT quality and how well the diversion is matched to the patient. Getting those three right, before you commit, is the whole game.
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Not sure it is needed?
For selected non-muscle-invasive disease, bladder-preserving options might still work. We check the MDT view before you agree to cystectomy.
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Worried about the diversion?
Ileal conduit, neobladder or continent pouch — each has trade-offs. You meet a specialist stoma nurse and see all three before you choose.
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Want it done properly?
A high-volume uro-oncology surgeon, a proper enhanced-recovery pathway, and a robotic option where it is the right fit — not just where it is available.
The journey
Staging to follow-up — what happens, in order.
One coordinator from first message through prehab, surgery and long-term follow-up — with the MDT and stoma nurse in the loop from the start.
Phase 1 · Before surgery
Staging, prehab, neoadjuvant chemo
Phase 2 · Admission and theatre
Enhanced recovery pathway
Phase 3 · After
Adjuvant therapy and follow-up
- 01
Before
Staging and multidisciplinary review
Cystoscopy and biopsy, CT of chest / abdomen / pelvis, and often an MRI bladder. Reviewed at a uro-oncology MDT so the plan matches the disease stage.
- 02
Before
Prehab and fitness assessment
Cardiopulmonary exercise testing (CPET) where indicated, anaemia correction, nutrition support, smoking cessation, and stoma-nurse counselling if a conduit is planned.
- 03
Before
Neoadjuvant cisplatin-based chemotherapy
For muscle-invasive disease the standard of care is 3–4 cycles of cisplatin-based chemotherapy before surgery — offered when your kidney function and fitness allow.
- 04
Admission
Admission and enhanced recovery
Same-day admission, carbohydrate loading, and an enhanced recovery pathway. Consent and marking with the surgeon and stoma nurse; regional analgesia planned with the anaesthetist.
- 05
Admission
The operation itself
Radical cystectomy with pelvic (or extended) lymph node dissection and the chosen urinary diversion. Robotic, laparoscopic or open, typically 4–8 hours in theatre.
- 06
After
Hospital stay and recovery
Usually 5–10 nights on an enhanced recovery pathway. Early mobilisation, stoma education if a conduit was formed, catheter care if a neobladder was fashioned.
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After
Adjuvant therapy and follow-up
Histology reviewed at the MDT. Adjuvant chemotherapy or immunotherapy where indicated, and structured follow-up with imaging, kidney function and B12 for the years ahead.
Typical end-to-end: 10–14 weeks from diagnosis to surgery (with neoadjuvant chemo). Full recovery: 8–12 weeks after theatre.
When it helps
When cystectomy is the right step.
The indications we see most, plus the red flag that means A&E rather than an outpatient call.
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Muscle-invasive bladder cancer
T2–T4a N0M0 urothelial cancer that has invaded the bladder muscle — radical cystectomy is the standard curative option.
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BCG-refractory high-risk NMIBC
High-grade non-muscle-invasive disease (CIS or T1 high grade) that has failed intravesical BCG — early cystectomy improves cancer-specific survival.
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Radiation-induced bladder haemorrhage
Intractable haematuria after pelvic radiotherapy that has failed conservative measures may need salvage cystectomy.
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Neurogenic bladder
A poorly compliant, high-pressure neurogenic bladder threatening the upper tracts, when reconstruction or diversion is safer than continued conservative care.
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Recurrent disease after bladder-sparing
Muscle-invasive recurrence after chemo-radiotherapy or repeated recurrence of high-risk NMIBC — salvage cystectomy is considered.
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Congenital anomalies
Rare congenital bladder anomalies (exstrophy, severe dysfunction) where reconstruction with urinary diversion is the definitive step.
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Partial cystectomy — selected cases
A solitary, organ-confined tumour in a favourable dome location, with no CIS elsewhere, may be suitable for bladder-preserving partial cystectomy.
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Red flag: sepsis or heavy bleeding
A high fever, spreading pain, drop in blood pressure or heavy per-urethral or stomal bleeding after surgery is an emergency — A&E, not a clinic call.
Procedure options
Approach and diversion — the choices that matter.
Open, laparoscopic or robotic; ileal conduit, neobladder or continent pouch; radical or partial. What each option actually involves — and which fits which patient.
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Open radical cystectomy
The established approach. A midline incision, removal of the bladder (and prostate or reproductive organs as needed), lymph node dissection and urinary diversion.
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Laparoscopic radical cystectomy
Minimal-access approach with small port incisions — less common now that robotic surgery is available, but still offered in selected units.
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Robotic radical cystectomy (RARC)
Increasingly the standard. Precise dissection through small ports, with intracorporeal or extracorporeal urinary diversion depending on surgeon and case.
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Partial cystectomy
Bladder-sparing removal of a segment of the bladder — reserved for a solitary organ-confined tumour in a favourable location, with strict selection.
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Ileal conduit (Bricker)
A short segment of ileum brought out as a stoma on the abdominal wall. The simplest, most predictable diversion — worn with a bag.
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Orthotopic neobladder (Studer)
A new bladder fashioned from ileum and joined to the urethra, so you void through the urethra. Requires suitable urethral anatomy, kidney function and motivation.
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Continent cutaneous pouch (Indiana)
A continent reservoir on the abdominal wall drained by intermittent self-catheterisation through a small stoma — no external bag.
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Pelvic lymph node dissection
Standard or extended template — done at the same operation for staging and to improve cancer control.
Our vetted UK network
A small panel of uro-oncology surgeons, we picked them.
High-volume consultant uro-oncology surgeons across the UK. Not listed publicly — introductions are made privately, once we understand your staging and the diversion likely to suit.
Selection criteria
How we choose every uro-oncology surgeon in our network.
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High-volume consultant uro-oncology surgeons with a dedicated cystectomy practice
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Robotic cystectomy team available where the case fits
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Ileal conduit, orthotopic neobladder and continent cutaneous pouch all offered
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Enhanced recovery pathway, specialist stoma nurses and dedicated uro-oncology MDT
Safety and recovery
What to expect afterwards — honestly.
Radical cystectomy is major surgery with a real complication rate. Enhanced recovery pathways and high-volume teams reduce that risk — but the trade-offs deserve a straight answer up front.
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Bleeding and transfusion
Radical cystectomy is major pelvic surgery. Blood loss can be significant and a transfusion is sometimes needed — cross-matched blood is on standby.
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Ileus is common
Slow return of bowel function after surgery is common and expected. Enhanced recovery, early mobilisation and chewing gum help; a nasogastric tube is used if needed.
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UTI and pyelonephritis
Urinary infections are common with any diversion. Prompt antibiotic treatment matters — recurrent infection needs review of the diversion and stents.
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Anastomotic and ureteric leak
A leak from the bowel or ureteric join is uncommon but serious. Watch for fever, worsening pain or drain output — call the team the same day.
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Stomal problems
Retraction, hernia, skin problems and rare stomal necrosis can complicate an ileal conduit — specialist stoma nurse review sorts most of them.
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Neobladder continence and voiding
A neobladder takes months to train. Night-time leakage is common early on, and some patients need intermittent self-catheterisation long term.
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Sexual dysfunction
Erectile dysfunction is common in men after radical cystectomy; vaginal shortening and dryness may follow anterior exenteration in women. Nerve-sparing is offered where oncologically safe.
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Vitamin B12 and metabolic acidosis
Using ileum for diversion can cause vitamin B12 deficiency and metabolic acidosis long term. Annual bloods and lifelong B12 monitoring are part of follow-up.
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Red flags
Fever, spreading redness, heavy bleeding, sudden abdominal pain, calf swelling or breathlessness after surgery are not normal — A&E the same day.
Reading your operation note
Your operation and histology note in four parts. Read the last one first.
Whichever approach and diversion were used, the note the surgeon and pathologist send you keeps to the same shape.
A quiet reminder
Surgical and pathology language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your MDT review, just ask.
- 01 Header
Indication and procedure performed
Why the operation was done — muscle-invasive bladder cancer, BCG-refractory NMIBC, salvage after radiotherapy — and whether it was radical or partial cystectomy.
- 02 Technique
Approach, diversion and lymph nodes
Whether open, laparoscopic or robotic; the type of urinary diversion (ileal conduit, neobladder, continent pouch); and the template of pelvic lymph node dissection.
- 03 Findings
Histopathology and margins
Tumour type and grade, pathological stage (pT and pN), surgical margins, lymphovascular invasion, and whether CIS was present elsewhere in the specimen.
- 04 Impression
Recovery, adjuvant plan and follow-up
Read this first: expected recovery, whether adjuvant chemotherapy or immunotherapy is recommended, and the schedule for surveillance imaging and blood tests.
Recognised by major UK insurers
Cover for cystectomy is usually funded by major insurers when medically indicated for cancer or refractory disease — pre-authorisation is required, and neoadjuvant chemotherapy sits under a separate benefit. We confirm cover before booking.
Frequently asked
Everything we get asked about cystectomy.
Straight answers on approach, diversion, chemotherapy, recovery, and the long-term issues that matter.
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What is a cystectomy?
A cystectomy is surgery to remove all (radical) or part (partial) of the bladder. For invasive bladder cancer it is combined with a urinary diversion — an ileal conduit, an orthotopic neobladder, or a continent cutaneous pouch — so urine can still leave the body.
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Radical or partial cystectomy — which is right?
Radical cystectomy is standard for muscle-invasive bladder cancer and for high-risk non-muscle-invasive disease that has failed BCG. Partial cystectomy is reserved for carefully selected patients with a single organ-confined tumour in a favourable location and no CIS elsewhere.
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Is robotic cystectomy better than open?
Robotic-assisted radical cystectomy (RARC) offers less blood loss and shorter hospital stay in high-volume centres, with equivalent cancer outcomes to open surgery in modern trials. The right choice depends on your anatomy, the disease and the surgeon’s experience.
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Do I need chemotherapy before surgery?
For muscle-invasive bladder cancer, cisplatin-based neoadjuvant chemotherapy before cystectomy improves survival and is the standard of care when kidney function and fitness allow. Your MDT will decide whether it is right for you.
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Ileal conduit, neobladder or continent pouch — which suits me?
An ileal conduit is the simplest and most predictable — worn with a stoma bag. A neobladder lets you void through your urethra but takes months to train and needs suitable anatomy and kidney function. A continent cutaneous pouch is a middle option — a continent reservoir drained by self-catheterisation.
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How long is recovery after a cystectomy?
Most patients stay in hospital for 5–10 nights on an enhanced recovery pathway. Full recovery — including regaining energy, adjusting to the diversion, and returning to normal activities — usually takes 8–12 weeks.
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How much does a private cystectomy cost in the UK?
Roughly £24,000–£38,000 for open radical cystectomy with an ileal conduit, £28,000–£45,000 for a robotic case with a conduit, and £32,000–£55,000 with a neobladder. We confirm a firm figure across two or three options within one working day.
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What are the long-term side effects?
Urinary infections, vitamin B12 deficiency, metabolic acidosis and changes in kidney function need lifelong monitoring. Sexual function is often affected. A neobladder takes patience to train, and some patients need intermittent self-catheterisation.
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When should I go to A&E after surgery?
A fever, spreading pain, heavy bleeding from the stoma or urethra, sudden abdominal pain, calf swelling or breathlessness are all reasons to seek same-day medical help.
Related tests
Looking for something else?
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Cystoscopy
Bladder inspection — the primary diagnostic test.
Learn more -
Flexible cystoscopy
Outpatient cystoscopy under local anaesthetic.
Learn more -
Rigid cystoscopy
Theatre cystoscopy with biopsy or resection where needed.
Learn more -
All tests
Every test and procedure we arrange.
Learn more -
Hypertension
Related condition guide.
Learn more -
Type 2 Diabetes
Related condition guide.
Learn more -
Blood Tests
Related diagnostic test.
Learn more -
Health Assessments Select
Related diagnostic test.
Learn more
In practice, in London
Why private cystectomy moves differently in London
For cystectomy, the private London route is mostly about consultant fit and hospital choice rather than raw waiting time. Waiting lists on the NHS for cystectomy vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
In practice, a private cystectomy appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For cystectomy in particular, we bias towards consultants who do this every week rather than every month.
Honesty about expectations is part of the job. A private cystectomy appointment in London won’t change the underlying medicine — the guidelines, the consultants, and the equipment are largely the same as on the NHS. What it changes is speed, continuity, and the amount of time you get to actually talk through the findings. Everyone we route to is GMC-registered and works within CQC-regulated facilities.