Coping with Muscle-Invasive Bladder Cancer Surgery Side Effects
- Football Hall of Famer Deion “Coach Prime” Sanders, 58, continues to speak openly about the long‑term side effects of bladder cancer treatment, including incontinence, helping normalize a topic many survivors struggle with privately.
- Sanders’s diagnosis became in Spring 2025 when he revealed a routine health check helped doctors discover he had a high-risk non-muscle invasive bladder cancer (MIBC), an aggressive form of the disease, despite having no symptoms.
- After surgery, which removed his bladder, he temporarily needed to use a urostomy bag [a medical device used to collect urine after bladder surgery]; however, he now occasionally uses a catheter to help him urinate.
- “We make an opening in the abdomen and create what’s called a urostomy or an ostomy. Essentially, we take a piece of intestine and use it as a conduit to carry the urine from the ureters out of the body through an opening in the skin called the stoma,” Dr. Piyush Agarwal, Professor of Surgery and Director of the Bladder Cancer Program at the University of Chicago, explained.
- “Surgery for bladder cancer is highly curative, but it’s associated with substantial impact on quality of life, and that impact is permanent,” Dr. Arjun Balar, Director of Genitourinary Medical Oncology at NYU Langone Health’s Perlmutter Cancer Center, told SurvivorNet.

After undergoing bladder cancer surgery, Sanders relied on a urostomy bag to collect urine following the removal of his bladder. Although he no longer needs the bag, he has shared that he may occasionally use a catheter to help him urinate.
Read More- Urostomy (ileal conduit)
- Neobladder
- Continent cutaneous pouch
Each approach works differently and comes with its own advantages and challenges.
Sanders utilized a urostomy bag. It works by collecting urine throughout the day. It is designed to be discreet and worn under clothing. Patients empty the bag periodically using a valve at the bottom. Most people empty the pouch several times per day, depending on how much they drink. At night, some patients connect their pouch to a larger drainage bag to allow uninterrupted sleep.
Modern ostomy appliances are designed to:
- Prevent leaks
- Protect the skin around the stoma
- Reduce odor
- Stay discreet under clothing
Many patients worry about how noticeable a urostomy pouch will be, but modern systems are flat and usually hidden beneath clothing.
A neobladder attempts to recreate a bladder using a segment of the small intestine. Instead of directing urine to an external pouch, surgeons construct a new internal reservoir that is connected to the urethra.
A cutaneous pouch, sometimes called a continent urinary diversion. This option is often used for patients who are not candidates for a neobladder but want to avoid wearing an external ostomy bag.
Sanders’ willingness to speak openly about these intimate challenges positioned him as the face of a new campaign supported by Depend, aimed at normalizing conversations around bladder leaks and survivorship.
“It helped to give me my life back,” Sanders says in the Depend ad, where he appears in all black against a dark backdrop, a single overhead light highlighting his face.
“It changes everything, but you. Take it from me, don’t be afraid to try Depend Guards. It can do for you what it’s done for me,” Sanders said.
“I used to think nothing could stop me, then bladder cancer and leak came up.”
His honesty extended beyond the campaign.
Following Deion Sanders’ battle with bladder cancer, he said he may need a porta-potty on the sideline…
He wasn’t joking ??
(via @Romi_Bean) pic.twitter.com/lo0I6Gmh5l
— Bleacher Report (@BleacherReport) August 30, 2025
Throughout the football season, Sanders even had a Depend-sponsored private sideline porta-potty enclosed by a curtain — a practical solution he embraced with humor and openness.
“I gotta make sure I pee before I go out there,” he said of the pregame ritual he developed after surgery.
“Sometimes, before the games, I use a catheter so I can make sure my bladder’s empty. Because when you feel it, you’ve got to use the bathroom, or you start leaking… You gotta take care of it.”

Dr. Arjun Balar, Director of Genitourinary Medical Oncology at NYU Langone Health’s Perlmutter Cancer Center, notes that Sanders’s experience is far from uncommon.
“Surgery for bladder cancer is highly curative, but it’s associated with substantial impact on quality of life, and that impact is permanent,” he told SurvivorNet.
By choosing to speak publicly about these realities, Sanders is helping dismantle stigma, broaden understanding of life after bladder cancer, and remind survivors that they’re not alone in navigating long‑term side effects.
Expert Resources for Bladder Cancer Patients
- Diagnosing Muscle-Invasive Bladder Cancer: The Initial Work-Up
- A Breakthrough For Muscle-Invasive Bladder Cancer: Padcev Plus Keytruda Drug Combo Could Transform Treatment Around Surgery
- Open Surgery vs. Robotic Assisted Surgery for Bladder Cancer
- The Newly-Approved Immunotherapy Drug Anktiva Can Help Early-Stage Bladder Cancer Patients Avoid Surgery
RELATED: Diagnosing Muscle-Invasive Bladder Cancer: The Initial Work-Up
What to Expect from Bladder Cancer Surgery
Sanders’ muscle-invasive bladder cancer is considered a more advanced stage of the disease.
While patient preference is central to treatment planning, doctors also evaluate several clinical factors that may determine whether surgery or bladder-preserving therapy is more appropriate.
These include:
- Age and overall physical fitness
- Other medical conditions (co-morbidities)
- Prior radiation treatments to the pelvis
“There are patients who would be at very high risk for adverse surgical outcomes based on potentially factors such as their level of activity, their age, their other medical comorbidities,” Dr. Elizabeth Wulff of the University of Kansas Medical Center explained to SurvivorNet.
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When bladder cancer is diagnosed, surgery may be recommended to remove the bladder and surrounding cancerous tissue to prevent the disease from spreading. Your treatment path will depend on several factors, including your overall health, the stage and grade of your cancer, and your personal preferences.
Understanding the Surgical Options
Bladder cancer surgery typically involves removing the bladder (a procedure called cystectomy) and nearby tissue. In many cases, a urinary diversion is also needed—this reroutes the flow of urine through a new pathway.
There are two main surgical approaches:
- Open Surgery
- This traditional method involves a single, large incision from the belly button downward. The surgeon uses their hands to access and remove the bladder directly.
- “Open surgery means making a cut on the skin and using our hands to do the operation,” explains Dr. Jay Shah, urologic oncology expert at Stanford Cancer Center.
- Robotic-Assisted Laparoscopic Surgery
- A minimally invasive technique using several small incisions. The surgeon operates robotic instruments to perform the procedure with precision.
- “Instead of one big cut, robotic surgery uses keyhole-size incisions and robotic tools,” says Dr. Shah.
Comparing Open vs. Robotic Surgery
Both approaches are effective for bladder cancer that hasn’t spread. The choice often depends on your surgeon’s expertise and your own preferences.
Open Surgery: Pros & Cons
Advantages:
- More surgeons are trained in this method
- Direct access to the bladder in emergencies
Considerations:
- More invasive, with longer recovery
- Higher risk of bleeding and infection
Robotic Surgery: Pros & Cons
Advantages:
- Less pain and blood loss
- Lower infection risk
- Shorter hospital stay and recovery
- Minimal scarring
Considerations:
- Not all surgeons are trained in robotic techniques
- May require travel to a specialized center
- Slightly higher risk of urinary tract infections
“What matters most is that your surgeon is experienced in the method they recommend,” Dr. Shah emphasizes. “You don’t want robotic surgery from someone who’s only trained in open techniques—or vice versa.”
Urinary Reconstruction & Diversion
If your bladder is removed, your surgeon will create a new way for urine to exit your body. This can be done using a portion of your intestine or an external collection system. These procedures are complex and often performed using open surgery.
Three common options include:
- Ileal Conduit: Urine flows through a stoma into an external bag, which is emptied throughout the day.
- Indiana Pouch (Cutaneous Continent Reservoir): A pouch made from intestine collects urine internally. A catheter is used to drain it through a stoma.
- Orthotopic Neobladder: A new bladder is constructed from intestine and connected to the urethra, allowing urine to exit the body naturally.
Your surgeon will recommend the best option based on your anatomy, health status, and lifestyle.
Making the Right Decision for You
Robotic cystectomy offers benefits like reduced pain and faster recovery, but open surgery may be better suited for complex cases. Studies show that long-term outcomes are similar between the two methods.
The most important factor? Choosing a surgeon who is skilled in the approach they recommend—and who takes the time to understand your needs.
Coach Prime’s Bladder Cancer Diagnosis
Deion Sanders played 14 seasons in the National Football League for several teams during his career, including the Atlanta Falcons and the Baltimore Ravens. The all-star athlete also played several seasons with Major League Baseball and the New York Yankees. Now, he is the head coach for the Colorado Buffaloes at the University of Colorado Boulder.
Despite his resilience on the gridiron, Sanders, a father of five, says his battle with cancer was one of his toughest.

In July, Sanders revealed that he had been battling bladder cancer. While specifics of Sanders’ cancer journey have not been fully disclosed, he shared that his experience “was tough” and said it “was a fight, but we made it,” according to the Associated Press.
Since 2021, Sanders has had 14 surgeries and dealt with blood clots, resulting in the amputation of two toes. A routine checkup helped lead to the discovery of his cancer diagnosis.
When Sanders’ doctors told him he had bladder cancer, the football star admits he was shaken by “the C word,” but remained steadfast; his diagnosis would be different, and he would survive.
Sanders’s bladder cancer was considered a “very-high-grade, malignant tumor” despite having no symptoms.
One of the things that kept Sanders headstrong during treatment was his desire to return to the football field and be the coach he dreamt of being.
“It was never in my spirit, in my heart, that God wouldn’t allow me to coach again,” Sanders said.

Sanders also admitted that he didn’t want to stress his sons with his health issues, as he didn’t want it to distract them.
“My sons, to this day, don’t know what transpired. I just told them it was something with my foot, because I wanted to give them the focus on making the team and not focus on dad,” he explained.
As part of his survivorship, Sanders is also using a urostomy bag [a medical device used to collect urine after bladder surgery].
Understanding How Bladder Cancer Impacts Patients
Your bladder is a hollow, muscular, balloon-shaped organ that expands as it fills with urine, an essential component of your body’s urinary system.
Bladder cancer begins when the cells lining the inside of the bladder start growing uncontrollably and form tumors. “Smoking is a leading risk factor,” with smokers being three times more likely to develop the disease than non-smokers.
Common symptoms of bladder cancer may include:
- Frequent urination
- Pain or burning during urination
- Flank pain (discomfort in the sides of the lower back)
- A sudden, urgent need to urinate
- Blood in the urine, which may appear pink, red, or cola-colored
Risk Factors for Bladder Cancer
Smoking is one of the most dangerous contributors to bladder cancer. In fact, the National Institutes of Health reports that roughly half of all bladder cancer cases are caused by smoking.
Why? The toxic chemicals in nicotine and other compounds found in cigarettes remain in the bladder for extended periods before being flushed out through urine—giving them more time to damage bladder tissue.
WATCH: Understanding bladder cancer risk factors.
“The first and foremost thing for a healthy bladder is, don’t smoke,” advises Dr. Arjun Balar. “I think that’s an obvious suggestion for a number of reasons. But if we can eliminate cancer risks that are related to smoking, that’s probably the most important thing you can do.”
Tobacco smoke is a toxic mix—the Centers for Disease Control and Prevention (CDC) says that it contains over 7,000 chemicals, with at least 70 known to cause cancer. While most often linked to lung cancer, smoking is also a major driver of other cancers, including bladder cancer.
Cigarette smoking is responsible for 80–90% of lung cancer deaths, and smokers are 15 to 30 times more likely to develop or die from lung cancer than non-smokers. Even exposure to second-hand smoke significantly increases risk.
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