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Cystectomy With Ileal Conduit

WHAT YOU SHOULD KNOW:

Cystectomy with ileal conduit is surgery to remove your bladder. Your surgeon will create a urostomy to help urine drain from your kidneys out of your body. A passage called an ileal conduit will be used to connect your kidneys to an opening in your abdomen. The opening, called a stoma, will be connected to a bag that collects urine.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Surgery may increase your risk for bleeding or infection. The stoma may become swollen or painful. Part of your intestine may bulge into the area around the stoma. Urine may leak where the ureters are connected to the section of intestine. Your ureters may also become blocked and not empty urine. Your intestines may stop working, and it may become difficult to have a bowel movement. You may get a blood clot in your leg or arm. Your symptoms may become worse if you do not have surgery. The above conditions may also become life-threatening.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Medicines may be given to prevent a bacterial infection or to prevent blood clots.

  • Anesthesia is medicine to make you comfortable during the surgery. Caregivers will work with you to decide which anesthesia is best for you.

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

    • Local anesthesia is a shot of medicine put into the skin of your abdomen. It is used to numb the area and dull the pain. You may still feel pressure or pushing during surgery.

During your surgery:

  • Your surgeon will make an incision in your abdomen near your umbilicus (belly button). He will remove your bladder and may remove nearby tissue or organs. In men, the organs include the prostate and seminal vesicles (glands near the prostate). In women, the organs include the uterus, cervix, ovaries, and fallopian tubes. Your surgeon may also remove part of the urethra and lymph nodes near your bladder.

  • Your surgeon will then remove part of your intestine. He will use this to connect your ureters to an opening in your abdomen. Two small stents (tubes) will be placed inside the ureters to help urine drain while you heal. Your surgeon will close your incision with stitches or staples.

After your surgery:

You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are okay, you will be able to go home or be taken to your hospital room. You may need to wear compression stockings to prevent blood clots from forming. Your caregiver will decide when it is OK to remove your nasogastric tube.

  • You may need to walk around the same day of surgery , or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • Deep breathing and coughing will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath. Then let the air out and cough. Repeat these steps 10 times every hour.

  • Total parenteral nutrition (TPN) is given through an IV. It provides your body with nutrition such as protein, sugar, vitamins, minerals, and sometimes fat (lipids). It is used when you have problems with eating or digesting food.

  • Medicines:

    • Antibiotics help treat or prevent an infection caused by bacteria.

    • Antinausea medicine calms your stomach and prevents vomiting.

    • Antiulcer medicine decreases the amount of acid that is normally made by the stomach. It can help to prevent a stomach ulcer after surgery.

    • Bowel movement softeners are given to make it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

    • Pain medicine may be given. Do not wait until the pain is severe before you ask for more medicine.

© 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.

Learn more about Cystectomy With Ileal Conduit (Inpatient Care)

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