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Cystectomy With Ileal Conduit: What to Expect at Home

Your Recovery

A cystectomy is surgery to remove part or all of the bladder. The surgery is mainly used to treat bladder cancer.

After surgery, your belly will be sore. You will probably need pain medicine for 1 to 2 weeks. You can expect your urostomy (stoma) to be swollen and tender at first. This usually improves after 2 to 3 weeks. You may notice some blood in your urine or that your urine is light pink for the first 3 weeks after surgery. This is normal.

While you are recovering from surgery, you will also be learning to care for your stoma. You may find it helpful to meet several times with a nurse who can teach you how to care for your stoma and use a urostomy pouch or bag.

Many people can return to work or their usual activities 4 to 6 weeks after surgery. But you will probably need 6 to 8 weeks to fully recover from the surgery.

Bladder cancer surgery may affect sexual function. If a woman's uterus and ovaries are removed during the surgery, she will not be able to get pregnant, and menopause may start. She may have hot flashes and other symptoms of menopause. And if a man's prostate gland and seminal vesicles are removed, he may have problems getting an erection and will not be able to make a woman pregnant.

You may feel sad or depressed, or you may worry about how your body will look after surgery. You may worry about whether the surgery will affect your ability to have sex. These concerns are common. Ask your doctor about support groups or other resources that can help you with this. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

Rest when you feel tired. Getting enough sleep will help you recover.
Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
Avoid lifting more than 2.5 kilograms for about 4 weeks or until your doctor says it is okay. This may include a child, grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
Ask your doctor when you can drive again.
You will probably be able to go back to work or your normal routine in 4 to 6 weeks. This depends on the type of work you do and if you have any further treatment.
You may take a bath or shower as usual. You can bathe with the pouch on or off. Gently pat the skin around your stoma dry after bathing.

Diet

You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
Drink plenty of fluids to avoid becoming dehydrated.

Medicines

Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- Do not take more than two pain medicines at the same time unless your doctor told you to. Many pain medicines contain Tylenol, which is also called acetaminophen. If you take too much acetaminophen, you can become very sick.
If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off.
Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
Keep the area clean and dry.

Other instructions

You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.
Follow your doctor's or nurse's instructions for caring for your stoma.
To control pain when you cough or sneeze, hold a pillow over your incision.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have chest pain, are short of breath, or cough up blood.

Call your doctor or nurse advice line now or seek immediate medical care if:

You have pain that does not get better after you take pain medicine.
You have loose stitches, or your incision comes open.
You are bleeding from the incision.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the area.
- Pus draining from the area.
- A fever.
You are not passing urine into your urostomy pouch.
You have symptoms of a urinary tract infection. These may include:
- Pain in the flank, which is just below the rib cage and above the waist on either side of the back.
- Blood in your urine, beyond the light pink colour expected in the first 3 weeks.
- A fever.
You are sick to your stomach or cannot drink fluids.
You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness or swelling in your leg.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

Where can you learn more?

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