Cystectomy With Continent Cutaneous Urinary Diversion

WHAT YOU SHOULD KNOW:

Cystectomy with continent cutaneous urinary diversion is surgery to remove your bladder. Your surgeon will create a urostomy to help urine drain from your kidneys out of your body. He will make a new bladder from a piece of your intestine. The new bladder will be connected to an opening called a stoma on your abdomen.

AFTER YOU LEAVE:

Medicines:

  • Anticoagulants are a type of blood thinner medicine that helps prevent clots. Clots can cause strokes, heart attacks, and death. These medicines may cause you to bleed or bruise more easily.

    • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth and a soft toothbrush. If you shave, use an electric razor. Avoid activities that can cause bruising or bleeding.

    • Tell your healthcare provider about all medicines you take because many medicines cannot be used with anticoagulants. Do not start or stop any medicines unless your healthcare provider tells you to. Tell your dentist and other caregivers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.

    • You will need regular blood tests so your healthcare provider can decide how much medicine you need. Take anticoagulants exactly as directed. Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.

    • If you take warfarin, some foods can change how your blood clots. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables, broccoli, grapes, and other foods. Ask for more information about what to eat when you take warfarin.

  • Take your medicine as directed. Contact your PHP if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your PHP or surgeon as directed:

You will need to return to have the stents removed, and you may need more tests. You will also need to return to make sure the stoma (opening on your abdomen) is healing. Write down your questions so you remember to ask them during your visits.

Wound and stoma care:

  • Carefully wash your incision wound and stoma with soap and water. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty. Rinse your new bladder 1 to 2 times a day with salt water. This keeps your bladder clean. Ask for more information on how to care for your stoma.

  • Use a catheter to drain your bladder every 2 hours for the first week. Drain your bladder every 3 hours for the next 6 weeks. After 6 weeks, drain your bladder every 4 to 5 hours.

Self-care:

  • Rest as needed. Slowly start to do more each day. Return to your daily activities as directed.

  • Prevent constipation. Eat foods that are high in fiber, and drink more liquids. High-fiber foods include fruits, vegetables, whole grains, and bran. This will help soften your bowel movements. Regular exercise and extra liquids may also help prevent constipation.

  • Ask which activities are safe for you. Do not lift heavy objects. Ask when you can return to work, drive, or have sex.

  • Do not smoke. If you smoke, it is never too late to quit. Smoking increases the time it takes for you to heal. Ask your PHP for information if you need help quitting.

Contact your PHP or surgeon if:

  • You have a fever.

  • Your stitches or staples come apart.

  • You have a fever or chills.

  • You do not get urine when you catheterize the stoma.

  • Your incision wound or stoma is red, swollen, or draining pus.

  • You have nausea or are vomiting.

  • You have questions or concerns about your condition or care.

Seek care immediately or call 911 if:

  • You cough up blood.

  • You feel lightheaded, short of breath, and have chest pain.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

  • Blood soaks through your bandage.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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