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Robotic cystectomy - radical bladder cancer surgery, done gently.

Da Vinci-assisted removal of the bladder with intracorporeal ileal conduit, orthotopic neobladder or continent pouch - extended pelvic lymphadenectomy, ERAS recovery and full oncology follow-up under one team.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private robotic cystectomy costs in the UK.

Indicative ranges across our partner robotic uro-oncology units.

In short

Robotic radical cystectomy with ileal conduit: £35,000–£55,000, home in 5–8 nights.

ProcedureIndicative range
Robotic radical cystectomy with ileal conduit £35,000–£55,000
Robotic radical cystectomy with orthotopic neobladder £45,000–£70,000
Robotic radical cystectomy with continent cutaneous pouch £45,000–£65,000
Robotic partial cystectomy (selected cases) £18,000–£28,000
Robotic salvage cystectomy after radiotherapy £45,000–£75,000
Consultant uro-oncology consultation £280–£450
Staging CT chest–abdomen–pelvis £550–£900

Prices vary by hospital, surgeon and diversion type. Neobladder, continent pouch and salvage cystectomy sit at the top of the range. Neoadjuvant chemotherapy is billed separately by the medical oncology team.

The problem

The right surgeon, the right diversion, the right neoadjuvant plan.

Radical cystectomy is one of the most impactful pelvic operations in urology. High-volume surgeons, intracorporeal reconstruction and a real ERAS pathway change the recovery - not the marketing.

  • Volume beats novelty

    A high-volume surgeon on a stable robotic platform beats a marginal-volume surgeon on the newest console. Ask for numbers.

  • Intracorporeal, not extracted

    Building the diversion inside the abdomen with the robot means less bowel handling and fewer wound issues than a mini-open extraction.

  • Neoadjuvant chemotherapy on the table

    For fit patients with muscle-invasive disease, cisplatin-based chemotherapy first is standard of care and improves survival. We plan it up front, not as an afterthought.

When it helps

When robotic cystectomy is the right operation.

The situations we see most, plus the one red flag that means MDT-first, not immediate surgery.

  • Muscle-invasive bladder cancer (T2 or higher)

    The core indication - invasion of the muscle layer on TURBT. Radical cystectomy is the standard-of-care curative option, alone or after neoadjuvant chemotherapy.

  • High-risk non-muscle-invasive disease

    BCG-refractory high-grade T1, carcinoma in situ resistant to intravesical therapy, or repeated high-risk recurrences.

  • Variant histology on TURBT

    Micropapillary, plasmacytoid, small cell or squamous variants - often behave more aggressively and are considered for early cystectomy.

  • Failed bladder preservation

    Recurrent or persistent invasive disease after trimodal chemoradiotherapy - salvage cystectomy, usually more complex and best done at high-volume centres.

  • Repeated symptomatic bladder pathology

    Refractory contracted bladder from radiotherapy, ketamine cystitis or severe interstitial cystitis where quality of life justifies removal.

  • Locally advanced pelvic cancer with bladder involvement

    Selected cases of colorectal, gynaecological or prostatic cancer requiring en bloc removal, in a multidisciplinary setting.

  • BCG intolerance in a fit patient

    Patients who cannot tolerate BCG for high-risk NMIBC and are unsuitable for alternative intravesical therapy.

  • Red flag: metastatic disease at presentation

    CT- or bone-scan proven metastases usually mean systemic therapy first, not immediate cystectomy - a uro-oncology MDT decision, not a private booking.

Procedure options

The right diversion depends on you.

Each variant, honestly explained - from ileal conduit and orthotopic neobladder to salvage cystectomy and organ-sparing techniques.

  • Robotic radical cystectomy - ileal conduit

    The workhorse diversion. A short segment of ileum is used to build a stoma on the abdominal wall. Simpler recovery, lifelong urostomy bag.

  • Robotic radical cystectomy - orthotopic neobladder

    A neobladder made from 40–60 cm of ileum, joined to the urethra. No external bag; voiding by relaxing the pelvic floor and Valsalva. Best for younger fit patients with a clear urethral margin.

  • Robotic radical cystectomy - continent cutaneous pouch

    A continent internal reservoir emptied by intermittent catheterisation through a small stoma at the umbilicus. Useful when neobladder is unsuitable but a bag is unwanted.

  • Robotic partial cystectomy

    Removal of a solitary tumour with a rim of normal bladder - reserved for very selected cases (urachal tumour, isolated dome lesion) after careful MDT review.

  • Robotic salvage cystectomy

    After failed radiotherapy or trimodal bladder preservation. Longer, more complex, higher complication rate - a high-volume-centre operation.

  • Extended pelvic lymphadenectomy

    Standard alongside radical cystectomy - from obturator up to the common iliac and presacral nodes. Robotic template is comparable to open in modern series.

  • Nerve-sparing techniques

    Preservation of the neurovascular bundles where oncologically safe, to protect erectile function in men and vaginal sensation in women.

  • Reproductive-organ-sparing cystectomy

    In selected younger women, sparing of the uterus, ovaries and anterior vaginal wall to preserve fertility and sexual function where oncologically safe.

Safety and recovery

What to expect afterwards - honestly.

Robotic cystectomy is one of the biggest pelvic operations we perform. The things worth planning are the first ten days on the ward, the neobladder or stoma learning curve, and lifelong surveillance.

  • A big operation, done as gently as possible

    Radical cystectomy is one of the largest pelvic operations in urology. The robot reduces blood loss and wound issues, but the recovery curve is real - plan on six to eight weeks off work.

  • Bleeding, transfusion and conversion

    Robotic radical cystectomy typically loses far less blood than open (median 300–500 mL). Transfusion rate under 20 percent in modern series. Conversion to open is under 5 percent in expert hands.

  • Infection, ileus and DVT

    Wound and urinary infection under 10 percent. Prolonged ileus 10–15 percent. DVT prophylaxis (stockings, heparin, early mobilisation) is standard.

  • Anastomotic leak from the diversion

    Urine or bowel leak from the reconstruction is the most feared early complication (2–5 percent) - the robot has not eliminated it, but ERAS and drainage protocols manage it well.

  • Erectile and sexual function

    Nerve-sparing techniques help but many men will need PDE5 inhibitors or other support after surgery. Frank counselling before surgery avoids surprise afterwards.

  • Neobladder function takes time to learn

    Continence during the day usually returns within 3–6 months; night-time continence takes 6–12 months. Voiding technique is taught by a specialist nurse.

  • Stoma care - practical, not scary

    A urostomy is manageable once you learn the routine. A dedicated stoma nurse marks the site pre-op and coaches you through the first weeks.

  • Metabolic and long-term issues

    Chronic acidosis, B12 deficiency and stone formation from bowel diversions require lifelong monitoring - annual bloods and imaging.

  • Red flags after surgery

    Fever, spreading redness, severe abdominal pain, no urine output, calf swelling or breathlessness need the same-day team or A&E, not a routine call.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever diversion was built, the note the surgeon sends you keeps to the same shape.

A UK consultant urologist reviewing a patient’s robotic cystectomy operation notes

A quiet reminder

Uro-oncology language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the note and histology before your review, just ask.

  1. 01 Header

    Approach, diversion and lymph-node template

    Robotic radical cystectomy, which diversion was built, and the extent of the pelvic lymph-node dissection.

  2. 02 Technique

    Intracorporeal vs extracorporeal

    Whether the diversion was built inside the abdomen with the robot or through a short extraction incision - with details of anastomoses and stents.

  3. 03 Findings

    Tumour stage, margins and node yield

    Pathological T stage, margin status (positive/negative), number of lymph nodes retrieved and any positive.

  4. 04 Impression

    Oncology plan and surveillance

    Read this first: whether adjuvant chemotherapy or immunotherapy is recommended, the follow-up imaging schedule and any stoma or neobladder training.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Robotic radical cystectomy for bladder cancer is usually covered on standard inpatient policies with pre-authorisation.

Frequently asked

Everything we get asked about robotic cystectomy.

Quick answers on outcomes, diversions, recovery and cost.

  • What is a robotic cystectomy?

    Robotic radical cystectomy is removal of the bladder - plus prostate and seminal vesicles in men, or uterus, tubes, ovaries and anterior vaginal wall in women - using the da Vinci robotic platform. A urinary diversion (ileal conduit, orthotopic neobladder, or continent pouch) is built at the same operation, ideally intracorporeally with the robot. The most common indication is muscle-invasive bladder cancer.

  • How does robotic cystectomy compare to open?

    Multiple randomised trials (RAZOR, iROC) show broadly similar oncological outcomes between robotic and open radical cystectomy in experienced hands. Robotic surgery typically reduces blood loss, transfusion rates, wound complications and length of stay. Operating time is often longer, particularly for intracorporeal diversion, and surgeon volume is the biggest determinant of results.

  • What is the difference between an ileal conduit and a neobladder?

    An ileal conduit uses a short bowel segment to bring urine to a stoma on the abdominal wall drained into a urostomy bag - simpler and quicker to recover from. An orthotopic neobladder uses a longer bowel segment to build a reservoir attached to the urethra so you can void more naturally, without a bag. Continence takes months to develop and night-time leakage is common in the first year. Not every patient is suitable - a clear urethral margin, adequate kidney function and motivation to catheterise if needed are essential.

  • How long does the operation take and how long will I be in hospital?

    Robotic radical cystectomy with intracorporeal diversion typically takes 5–8 hours depending on the diversion and surgeon volume. Hospital stay in an enhanced recovery pathway averages 5–8 nights for an ileal conduit and 7–10 nights for a neobladder. Salvage cystectomy after radiotherapy is longer.

  • How much does a private robotic cystectomy cost in the UK?

    Roughly £35,000–£55,000 for robotic radical cystectomy with ileal conduit, £45,000–£70,000 with orthotopic neobladder, and £45,000–£75,000 for salvage cystectomy after radiotherapy. The figure includes surgeon, hospital, anaesthesia, robot fees and inpatient stay.

  • Will insurance cover it?

    Robotic radical cystectomy for bladder cancer is usually covered by UK private insurers on standard inpatient policies, subject to pre-authorisation and referral. Some insurers still require a case for use of the robot over open surgery.

  • What about neoadjuvant chemotherapy?

    For fit patients with muscle-invasive bladder cancer, cisplatin-based neoadjuvant chemotherapy (typically 3–4 cycles) before radical cystectomy is standard of care and improves survival. Not everyone is eligible - renal function, hearing and general fitness matter. The MDT decides jointly with you.

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