Cystectomy With Ileal Conduit: What to Expect at Home

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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, and 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.

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.
  • 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 call line 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 severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.
  • You have severe belly pain, or nausea and vomiting.

Call your doctor or nurse call 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 incision.
    • Pus draining from the incision.
    • Swollen lymph nodes in your neck, armpits, or groin.
    • A fever.
  • You have little or no urine going into the pouch.
  • Your urine becomes cloudy or smells very bad.
  • You have pus or clots of blood in your urine.
  • You have pain in your back just below your rib cage. This is called flank pain.
  • You have a stoma and:
    • It turns pale or dark purple.
    • It swells or bleeds.
    • You have signs of infection, such as red streaks or pus around your stoma.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if:

  • You do not have a bowel movement after taking a laxative.
  • You are not getting better as expected.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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