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Cystectomy with Continent Cutaneous Urinary Diversion

WHAT YOU NEED TO KNOW:

Cystectomy with continent cutaneous urinary diversion is surgery to remove your bladder. Your surgeon will create a new way for urine to drain out of your body. He or she 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. You will empty urine through a catheter you will guide through the stoma and into the new bladder.

Kidney, Ureters, Bladder

DISCHARGE INSTRUCTIONS:

Call your local emergency number (911 in the US) for any of the following:

  • You have chest pain.
  • You feel lightheaded or short of breath.
  • You cough up blood.

Seek care immediately if:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • Blood soaks through your bandage.

Call your doctor 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.

Medicines:

  • Blood thinners help prevent blood clots. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any other medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Take your blood thinner exactly as prescribed by your healthcare provider. Do not skip does or take less than prescribed. Tell your provider right away if you forget to take your blood thinner, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin:
      • Foods and medicines can affect the amount of warfarin in your blood. 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 and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her 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.

Wound and stoma care:

  • Carefully wash your incision wound and stoma. Use 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 saline (salt water). This keeps your bladder clean. Ask for more information on how to care for your stoma.

Self-care:

  • Rest as needed. Slowly start to do more each day. Return to your daily activities as directed.
  • Use a catheter to drain your bladder. Drain your bladder every 2 hours for the first week. Drain your bladder every 3 hours for the next 6 weeks. Drain your bladder every 4 to 5 hours after 6 weeks.
  • 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. You may have problems with sex after your surgery. Talk to your healthcare provider if you have any problems or concerns.
  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause blood vessel damage. Smoking can increase the time it takes for you to heal. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Follow up with your doctor 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 is healing. Write down your questions so you remember to ask them during your visits.

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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 Continent Cutaneous Urinary Diversion (Discharge Care)

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