What are the contraindications to partial cystectomy?

Updated: Apr 03, 2019
  • Author: E Jason Abel, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

In patients with bladder cancer being considered for partial cystectomy, the entire urothelial tract from the kidneys to the urethra must be evaluated thoroughly. Prior to surgery, no other malignant disease should be anywhere in the urinary tract. The presence of multifocal disease or CIS is considered an absolute contraindication to partial cystectomy.

Other contraindications to partial cystectomy include the following:

  • Cellular atypia in random biopsy specimens

  • Prostatic invasion

  • Bladder neck or trigonal invasion

  • Presence of lymphovascular invasion in biopsy specimen

  • Inability to achieve adequate surgical margins

  • Prior radiation therapy

  • Inadequate bladder volume following resection

  • Evidence of metastatic disease

  • Poor preoperative performance status conveying high surgical risk


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