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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

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.
  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.
  • An enema may be given to help empty your bowel. An enema is liquid medicine put in your rectum.
  • Medicines may be given to prevent a bacterial infection or blood clots.
  • General anesthesia will be given to 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.

During your surgery:

  • Your surgeon will make an incision near your belly button. He or she will remove your bladder and may remove nearby 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 may remove part of your intestine. He or she will make a new bladder by connecting the section of intestine to your ureters. Two small stents (tubes) will be placed inside the ureters into the kidney to help urine drain while you heal. Your surgeon may also use part of your appendix. The incision will be closed with stitches or staples. You will learn to empty your urine by pushing the urine out. You will use pelvic abdominal muscles to help push out the urine.
  • Your surgeon may instead connect your 2 ureters to a pouch on one end. The other end attaches to the opening on your abdomen. The opening will be covered with a bandage. Urine will collect in the pouch and you will need to use a catheter to drain urine from the pouch.

After your surgery:

You will be taken to a room to rest until you are fully awake. Healthcare providers will monitor you closely for any problems. Do not get out of bed until your healthcare provider says it is okay. When your healthcare provider sees that you are okay, you will be able to go home or be taken to your hospital room.

  • Medicine may be given to manage pain. Medicines may also be given to treat or prevent an infection caused by bacteria, or to prevent nausea and vomiting. You may also be given medicine to decrease stomach acid or to make it easier to have a bowel movement.
  • You will be helped to walk around after surgery. Movement will help prevent blood clots. Do not get out of bed on your own until your healthcare provider says you can. Talk to healthcare providers before you get up the first time. They may need to help you stand up safely.
  • 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.
    How to use and Incentive Spirometer
  • Drains may be coming out of the surgery area. Drains are used to remove blood or fluid from the area.
  • Catheters may be used to drain urine from the new bladder. You will be taught how to insert a catheter into the stoma to drain urine from your bladder. You will need to do this several times each day.
  • You may be taught to push urine out. You will learn to use abdominal and pelvic muscles. You will need to push urine out several times each day.
  • Intake and output may be recorded. Healthcare providers record the amount of liquid you are getting and how much you are urinating. Healthcare providers may need to strain your urine to check for stones. Do not flush your urine down the toilet unless healthcare providers say it is okay.
  • Bladder irrigation keeps your bladder clean and helps it heal. Healthcare providers will irrigate your bladder 2 to 3 times a day.

RISKS:

Surgery may increase your risk for bleeding or infection. Urine may leak where the ureters are connected to the section of intestine. Your ureters may also become blocked and not empty urine. You may develop a life-threatening blood clot.

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 healthcare providers to decide what care you want to receive. You always have the right to refuse treatment.

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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 (Inpatient Care)

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Further information

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