Surgery for muscle invasive bladder cancer
There is a risk of problems or complications after any operation. Many problems are minor but some can be life threatening. Treating them as soon as possible is important.
After surgery to remove your , you need another way to collect and pass your urine. Doctors call this urinary diversion. There are different types of urinary diversion. Some of the possible problems depend on which type of urinary diversion you have.
Read about the different types of bladder cancer surgery
After any major operation there is a risk of:
You are at risk of getting an infection after an operation. This includes a wound, chest or urine infection. Symptoms can depend on where the infection is. Tell your doctor or nurse if you have any symptoms of infection.
These include:
a high temperature
shivering
feeling hot and cold
feeling generally unwell
cough
feeling sick
swelling or redness around your wound and your wound might feel hot
a strong smell or liquid oozing from your wound
loss of appetite
cloudy smelly pee
If you get an infection, your doctor gives you antibiotics to treat it.
Sometimes for an infection in your wound, you may need another operation. But this is rare.
Blood clots are also called a deep vein thrombosis or DVT. They are a possible complication of having surgery because you might not move about as much as usual. Clots can block the normal flow of blood through the veins. Let your doctor or nurse know if you have an area in your leg that is swollen, hot, red or sore.
There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs. This causes a blockage called a pulmonary embolism. Symptoms include:
shortness of breath
chest pain
coughing up blood
feeling dizzy or lightheaded
To prevent clots it's important to do the leg exercises that your nurse or taught you. And to move around as much as possible. Your nurse might also give you an injection just under the skin to help lower the risk whilst you are in hospital. You might need to carry on having these injections for a few weeks, even after you go home. This depends on the type of operation you had.
Your nurse might teach you to do these injections yourself before you go home. They will make sure you are comfortable doing them. Or a district nurse might come to your home to do them.
It's important to continue wearing your anti embolism stockings if you have been told to by your doctor.
Chest infections, including pneumonia, can be serious.
You can lower your risk by:
stopping smoking before your operation
getting up and moving as soon as possible after your operation
doing any breathing exercises your physiotherapist teaches you
If you get an infection, you have antibiotics to treat it.
There is a risk that you will bleed after your operation. The team looking after you will monitor you closely for signs of bleeding. The risk of bleeding is greatest straight after your operation and is much lower after 3 or 4 days.
The treatment you need depends on what is causing the bleeding and how much blood you lose.
You might need a . Rarely, you might need to go back for urgent surgery.
Your bowel might be slow to start working after surgery. Doctors call this ileus. This can cause bloating, nausea and vomiting.
Treatment includes:
stopping eating and drinking and having fluids through a drip
a tube down your nose into your stomach (nasogastric tube) to drain bile and stop you feeling sick
This usually gets better with time.
Bladder cancer surgery might affect how well your kidneys work. Your kidney function might get worse over time. This can happen for several reasons. For example, if your urine isn’t flowing as well as it should. Or if you have repeated urine infections.
Your doctors will do regular tests after your operation to see how well your kidneys are working. And to see if this changes.
Leaks can happen where the surgeon joins the bowel back together. Or where they join the to the or new bladder. This is called an anastomotic leak. This is a serious problem and you need to have treatment straight away.
Treatment depends on where the leak is and might include:
draining the leak
not eating or drinking
If the leak is urine, you will need:
a tube through your skin to collect urine directly from your kidney (a nephrostomy tube)
a tube that drains urine from your ureters (ureteric stent)
You will have and scans to check that the area is healing. You might need more surgery to repair the leak if the other treatments don’t work.
You might need to stay in hospital longer if you have a leak.
The tubes that drain urine from your kidneys (ureters) may become narrower over time. This can happen because of scarring and is called a stricture.
If you develop a stricture, your doctor can stretch the ureter slightly. They call this dilatation and it opens up the ureter again. They might also put in a thin tube (ureteric stent) to keep the ureter open.
You might need to have this repeated if the narrowing happens again. Some people might need to have surgery to repair the stricture.
The ileum absorbs vitamin B12. Your surgeon removes part of your bowel (ileum) to make either a new bladder or an ileal conduit. Therefore you might have a shortage (deficiency) of vitamin B12, folate and vitamin D after surgery if they have removed a large part of your ileum. Your doctor will monitor your levels.
You will have to monitor the levels of waste products (metabolites) in your blood. The wall of your new bladder or ileal conduit is made of bowel. When it is holding urine, this bowel wall can reabsorb some of the waste metabolites in the urine.
With any surgery to your tummy (abdomen), there is a small risk of a hernia forming at the surgical site.
Your surgeon will advise you to avoid activities or exercises that put strain on the abdominal wall. This will be for a period of time after surgery. It includes activities such as lifting boxes, hoovering and certain gym exercises.
If your job involves heavy lifting, you should discuss this with your occupational health advisor at work.
If you have a , there is a risk of a hernia around the stoma. You should avoid regular heavy lifting. There are stoma appliances that can support the stoma and reduce complications caused by the hernia.
This operation might affect your sex life.
Women
For some women, the surgery might shorten your or make it narrower. Sensations during sex may feel different. Your surgeon might also remove your during surgery. This means you can’t have children.
Talk to your specialist nurse or surgeon about this before your surgery. They can offer you support and tell you what you can do to help with some of these changes.
Men
Your surgeon also removes your when they remove the bladder. This means you will not be able to . So your orgasms will be dry. This operation can also damage the nerves that control your erections. So you may not be able to get an erection anymore.
After your surgeon removes your prostate gland, you can no longer father a child.
Talk to your surgeon or nurse specialist about this before surgery. They can offer you support and tell you what you can do to help with any changes to your sex life.
Read more about how cancer and treatment can affect your sex life
Some people leak urine after a bladder reconstruction, particularly at night.
Your surgeon and specialist nurse will talk to you about how common this is. They will tell you whether it is likely to be a problem for you.
They can advise you what to do about it if it happens. And what might help. For example, they might tell you how to do regular pelvic floor exercises to strengthen your pelvic floor.
Lymphoedema is a build up of that causes swelling in a part of the body. It can develop if there are problems with the .
As part of your surgery your surgeon usually have some of the around your bladder. This means you are at risk of lymphoedema in your legs. This is because surgery can damage the lymph pathways and block the normal drainage of lymph fluid.
You might need to wear supportive garments. Your surgeon or specialist nurse will refer you for help with this.
Bladder cancer surgery can cause bowel changes. This is because the surgeon removes part of your bowel and it is now shorter. You may notice that:
your poo is looser than normal
you go to the toilet more frequently
you get constipated and need medicine to help you go
It can take some time to return to normal, often a few months or longer.
Last reviewed: 20 Aug 2025
Next review due: 20 Aug 2028
Surgery is one of the main treatments. The surgeon usually removes all your bladder and makes a new way for you to pass urine.
The main treatments for muscle invasive bladder cancer are surgery, chemotherapy or radiotherapy.
Get practical and emotional support to help you cope with a diagnosis of bladder cancer, and life during and after treatment.
After treatment for muscle invasive bladder cancer, you have regular check ups. This is called follow up.
Bladder cancer is cancer that starts in the lining of the bladder.
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