Radical Cystectomy – Bladder Removal Surgery

What to Expect After Your Surgery

Radical cystectomy is major surgery and you’ll have a lengthy recovery. Many parts of the body are affected during the surgery and need time to heal.

On average, your hospital stay will be 5 to 10 days. Walking starts the day after surgery to help the bowels to start working again. Remember, this is bowel surgery too, not just bladder surgery and expect to be on a liquid diet for the first few days before solid foods are gradually introduced.

While in hospital, you’ll have a number of IV lines and tubes, depending on your type of surgery. These will provide pain control, urine drainage and drainage of excess fluid from the surgical site.

Common Issues Following A Radical Cystectomy Surgery

Radical cystectomy and creating a urinary diversion is major abdominal surgery. As with all major surgeries, some issues may arise.

• Temporary loss of appetite
• Reduced energy
• Fatigue
• Loss of weight
• Infections
• Erectile dysfunction in men (you need to discuss potential treatments for this with your surgeon)
• Painful intimacy in women
• Body image issues
• Anxiety
• Feeling “different”
• Mucus in urine (which is continually produced by the intestinal section used to make the diversion) is unsightly and can potentially cause blockage and the need for catheterization

Returning Home After Surgery

It’s not unusual for your weight to change during your hospital stay and first few weeks at home. There will be some muscle and fat weight loss, but there could be some weight gain through fluid retention. The excess fluid will gradually be cleared by the kidneys.

You’ve had major surgery, so your recovery will be gradual. Keep a record of your progress – how many and what length of walks you’ve taken (even walks in the hallways of your home count).

You may also need soft, small icepacks (your groin area will be swollen for a while, which is a normal part of healing). In men, the scrotum, which contains the testicles, may swell considerably.

It’s important to keep the incision clean and dry until it heals. Home care is usually ordered to check on dressings and change them and to remove the stitches or staples. If you have any issues, call the urologist. If you develop a fever, go to the nearest Emergency Room as soon as possible as it may be an indication of infection.

Nutrition & Exercise

You’ll need to eat small, frequent meals, which are easier on the healing bowels and shrunken stomach. You must drink at least 64 ounces of water (eight 8-ounce glasses of water or other liquids) per day. This is necessary to keep the kidneys clear, keep mucus thinner and easier to pass and not block up anywhere, and keep stools softer and easier to pass. Mucus will continue to be produced by the parts of the intestines that were used for the diversion, probably forever.

So, drinking lots of water will become a lifetime commitment.

Soups and stews are easy to digest, easier on the healing bowels and the easiest way to keep high nutrition for healing (try grating vegetables into soups or stews). For the first weeks, avoid fats and high-fibre foods, like popcorn and raw or undercooked vegetables.

The bowels need gentle physical activity to start working again. Walking is the best form of exercise for the first six weeks to three months – the body’s healing time.

Bowel Care

You’ll need to keep your stool soft as the bowel heals. Daily stool softeners may be recommended and are available over the counter at drug stores. You’ll want to limit straining while having a bowel movement to help the bowel heal, avoid putting a strain on the stitches or staples and reduce the risk of haemorrhoids.

If you are constipated, some fibre intake may help, but it also means drinking plenty of water, as the fibre needs lots of water to work as a softener – the fibre can cause constipation if you don’t drink enough water. There are cases where a blockage can occur in the bowel, often at the point where the sections of the bowel were re-joined during surgery. Walking a lot will help and sometimes chewing gum is recommended.

Emotions

Your emotions can best be described as a rollercoaster. That’s perfectly normal – after all, you’ve been diagnosed with cancer, you’ve had major abdominal surgery, and you’re faced with a new lifestyle. It helps to have supportive family and friends around you. Don’t be afraid to express your emotions by talking to others who’ve gone through the same thing.

Focus on your task your recovery and creating a new lifestyle. Remember, a positive attitude will be a key element in your recovery.

Contact us and we can put you in touch with someone to talk with about your emotions.

You’ll find more information about dealing with your emotions here.