What is a cystectomy with continent reservoir?
A cystectomy is surgery to remove part or all of your bladder. Sometimes other organs, lymph nodes, and part of the urethra are also removed. The urethra is a tube that carries urine from your bladder to outside your body.
To do the surgery, your doctor makes a cut in your lower belly. This cut is called an incision. If the doctor takes out all of your bladder, he or she will need to make a new way for you to pass urine. This is called a continent reservoir. It's a storage pouch that attaches inside your pelvis. It's made from a piece of your bowel. There are two types.
- A bladder substitution reservoir is used if your urethra is not removed. It's also called a neobladder. One end connects to your ureters. These are the tubes that carry urine from the kidneys to the bladder. The other connects to your urethra. With this type, you can urinate much as you did before surgery.
- A continent diversion reservoir with stoma is used if all or part of your urethra is removed. It's also called a urostomy. One end connects to your ureters. The other connects to an opening the doctor makes in your belly. This opening is called a stoma. When you want to urinate, you put a thin plastic tube through the stoma. The tube is called a catheter.
In the hospital, a nurse with special training will teach you how to care for your reservoir. Most people go home in 1 to 2 weeks. But you will probably need 6 to 8 weeks to get back to your usual routine. If your surgery was done to treat bladder cancer, you may need other treatments. These include chemotherapy and radiation therapy.
Surgery to remove your bladder may affect your sexual or reproductive life. But if a woman also has her uterus and ovaries removed, she will not be able to get pregnant. She could also start menopause and have hot flashes or other symptoms of menopause. And if a man has his prostate gland and seminal vesicles removed, he may have problems getting an erection. He will also not be able to get a woman pregnant. If you are a man who may want to father a child in the future, talk to your doctor. There are ways to save your sperm before the surgery.
It's common to feel sad or worried about how this surgery will affect you. It may help to join a support group. You can ask your doctor about these groups. You can also call the Canadian Cancer Society (1-888-939-3333) for more information. Or you can visit its website at www.cancer.ca.
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 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.
How do you prepare for surgery?
Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.
Preparing for surgery
- Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own. For your safety, you should not drive until you are no longer taking pain medicines and you can move and react easily.
- Arrange for extra help at home after surgery, especially if you live alone or provide care for another person.
- Understand exactly what surgery is planned, along with the risks, benefits, and other options.
- If you take aspirin or some other blood thinner, ask your doctor if you should stop taking it before your surgery. Make sure that you understand exactly what your doctor wants you to do. These medicines increase the risk of bleeding.
- Tell your doctor ALL the medicines and natural health products you take, including any vitamins and supplements. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
- Before your surgery, you will speak with an anesthesia provider to discuss your anesthetic options, including the risks, benefits, and alternatives to each. This may be on the phone or in person.
- Make sure your doctor and the hospital have a copy of your advance care plan. If you don't have one, you may want to prepare one. It lets others know your health care wishes. It's a good thing to have before any type of surgery or procedure.
Taking care of yourself before surgery
- Build healthy habits into your life. Changes are best made several weeks before surgery, since your body may react to sudden changes in your habits. Talk to your doctor about any changes you need to make.
- Stay as active as you can.
- Eat a healthy diet.
- Cut back or quit alcohol and tobacco. If you drink a lot of alcohol, talk to your healthcare provider about helping you cut down the amount you drink.
Where can you learn more?
Go to https://www.healthwise.net/patientEd
Enter T938 in the search box to learn more about "Cystectomy With Continent Reservoir: Before Your Surgery".