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RadicalRadical CystectomyCystectomy::
IndianaIndiana PouchPouch
ThisThis guideguide willwill explainexplain what what to to expect expect before, before, during during and and afterafter yyourour surgerysurgery andand hospital hospital stay. stay. These These are are general general guidelinesguidelines,, butbut somesome things things may may change change based based on on your your needsneeds asas aa patient.patient. Knowing Knowing what what to to expect expect and and being being an an activeactive participantparticipant inin your your surgical surgical process process are are key key to to a a successfulsuccessful recovery.recovery. If If you you have have questions, questions, please please do do not not hhesitatesitatee toto askask yyourour care care team; team; we we are are hap happypy to to address address your concerns! Please use the space for notes to write your concerns! Please use the space for notes to write down any questions you may have for your care team down any questions you may have for your care team and fill in your appointment information! and fill in your appointment information!
A Guide to Your Daily Care
Understanding Your Procedure:
Radical Cystectomy is the removal of the entire ladder near y lym h nodes art of the urethra and other organs that may contain cancer cells
he surgeon removes the bladder and surrounding lym h nodes For males the rostate is also removed For females the uterus cervi fallo ian tu es ovaries and art of the vagina are removed In men the rostate seminal vesicles and art of the vas deferens are also removed
t the time of surgery you ill receive general anesthesia hich means that you ill e deeply asleep and ill not feel any ain t this oint you ill have a reathing tu e
our doctor ill need to find a ne ay to drain urine his ill e done y creating an Indiana Pouch. our intestine is made into a pouch that is connected to the stomach ou need to ut a sterile catheter through the stoma into the ouch to drain the urine
>SURGEON’S BUSINESS CARD TO BE
P R
Your Urological Surgery Team
Urological Surgeon: ______Your attending doctor i your urgeo a i i c arge o your care a all care eci io ll mem er o your urology tea re or o your urgeo uri g your ay you ill e a e care o y e urology eam T e eam or a commu ica e clo ely a ou your care Residents: ______ e i e are lice e oc or i eir ir o i year o training T ey are a ac i e ar o your urology eam a ill ro i e a ig ar o your care T i i clu e el i g e a e i g oc or i o era io er ormi g roce ure ri i g or er a re cri i g me ica io Fellows: ______ ello are oc or a a e i i e eir re i e cy rai i g a are ecomi g s ecialists T ey are a ac i e ar o your urology eam a ill ro i e a ig ar o your care T i i clu e el i g e a e i g oc or i o era io er ormi g roce ure ri i g or er a re cri i g me ica io Physician Assistant: ______ y icia i a are lice e eal care ro i er i ecial rai i g a ro i e su ort o me ical a u er e u er i io o a oc or T ey ca al o c ec your rogre a re ue io a co cer a re cri e me ici e re cri io Nurse Practitioner: ______ ur e rac i io er a e a a ce e uca io a rai i g o ta e care o a ie T ey ca or er e ro i e rea me a or er me ica io u er u er i io o a oc or Nurses: ______ ur e a e care o your daily needs gi e you me ici e a el i rea me ur e ca al o ro i e e uca io a commu ica e a ou your care i e Urology eam Stoma Nurse: ______T e oma ur e eciali e i e care o e urosto y T i ur e ill ro i e i orma io a eac i g a ou e care o your o omy e ore a a er urgery T i ur e ill mar ere your oma ill e e ore urgery Care Coordinator: ______T e are oor i a or ill mee i you a er your urgery i e o i al T ey ill or i you your amily a e eal care eam o la or o e care or re a ilitation a er you lea e e o i al T ey ca al o a er a y i ura ce or i a cial ue io you may a e Visiting Nurse: ______T e i i i g ur e ill come o your o e a el you care or your el a your i ci io T i ur e ill el you a your amily lear e e ill or care a er urgery a ell a el i a y ue io you may a e
Preparing for Surgery
e ore urgery your Urology Team ill c e ule a re o erati e testing a oint ent T i a oi me mu e i i ay o your urgery re era ly ee e ore You ill mee i a eal care ro i er o ma e ure you are eal y e oug o a e urgery a o recei e a e e ia T i i ere you ill recei e your Pre A oint ent lear a car o y ra e a e ri o a e our e ore urgery You may Time al o mee i a oma oca io ur e i ee e
lea e ri g a co lete list o your edica tions and su le ents i clu i g o e a re ue cy Your Urology Team ill ell you ic me ica io o o a i g e ore urgery
f you a e a pirin for a ear on i ion c ec it your eart doctor e ore a ing any c anges
you ta e edication t at t ins your lood you s ould sto ta ing it e ore surgery Do not sto t is on your o n ou ou on a e pre ri ing pro i er o a a ou a p an for opping i efore urgery a p e in u e arfarin ou a in P a i o eno are o er oo inning e i a ion in u e o er e oun er uprofen pirin an e e
*If your blood thinning medications cannot be stopped, please contact your surgeon to discuss.
o e p i re o ery efore your urgery i e p o er i e regu ar y S op o ing e rea e a o o in a e
e re o en a you a en our e u a iona a on a o e pe efore uring an af er your surgery. Ask your doctor’s office about getting e u e for e Cystecto y Class
Notes
One Day before Surgery:
e e o e s e you ay ea a you nor a y o
te t o t e t e o e s e you ay no ea any so oo s n u ng e o o s or ts
e se o your e o t o s e t e an t e by Surgery Da e: a ng e a bu ne rr a e: ay before your urgery f your urgery on a Surgery e: on ay ea e a e r ay before :
Brigham and Women’s Hospital: be een : an :
and Women’s e os t : o on be een : an :
Notes
The Day of Surgery o to three ho rs e ore o r s hed led s rger time drin rin the lear ast ar oh drate lear ast drin ha you ere g e a your T e re o era e a o e
rri e a he a g e ar e a your he u e e o e for ar g a raff
onta t pport lease hoose one onta t erson person Th er o e he o e o he you for he f r fe a e ee af er your urgery our urgeo o a h er o e a o h af er urgery h a u a e ho e
Be ore s rger your urg a ea a er a y ue o ha you ay ha e ou a u e he o e e o hroughou h a e o r e o a y ue o a hey ar e
ou ay ha e a epid ral a e y he a e he a ea Th a a of u e a e your a The e ura e er e a o ha he re u e your a
ou ha e a intra eno s ee e your ar for f u a e a o o he you re a
ou ge pain medi ations hrough he a or epid ral
our e o e y e her dissol a le stit hes or staples
ter s rger you e he re o er room for a u of hour a you a e u fro he a e he a The ea o fy your o a er o he hey a you
After Surgery (In Hospital)
After your pro e ure your surgi al tea ill a e you rin small sips o li id ou s oul not eat any soli foo s at t is ti e
ou ill ear ompression oots t at s uee e t e otto of your legs to eep t e loo flo ing is elps to pre ent loo lots fro for ing
ou ay also re ei e lood thinning in e tions to pre ent loo lots
a a ter s rger you ill e on a lear li ui (no soli s) iet a ples in lu e ater la offee lear tea apple ui e ran erry ui e an sports rin s ou ill get out of e for ours if possi le ry to al at least ti es it assistan e fro t e e i al staff e ing gu is en ourage to elp get your syste a to nor al
a a ter s rger ou an eat a regular iet as tolerate eep al ing
en you an tolerate foo or rin nor ally you an ta e pain medi ine mo th
our nurse ill or it you to ontrol your pain an is o fort after surgery
ile you are in t e ospital t e nursing staff ill e on you often to onitor ain ital signs lui inta e an o tp t fro your ne sto a
a s ter rger ou s oul get o t o ed and al times ea h da or a total o ho rs his helps ith o r re o er ou an lea e t e ospital on e you an at al safely a e pain e i ine
ost patients stay in t e ospital for da s Notes
When You Are At Home Symptoms
These symptoms are abnormal – please contact the Urology office or call 9-1-1 if you have any of the below symptoms:
ot producin urine ever o more than de rees Pain that doesn’t improve with medication omitin hest ti htness or shortness o reath e swe in our stoma turns re or ue Do not panic – these symptoms are normal!
ruisin ee in tired ecreased appetite rre u ar owe movements uid ea a e rom urethra ucus ood titches disso ve tents a out ear Activity You shou d t st tim s p y to reduce the ris o ood c ots and comp ications You ma wa up down stairs
o ot i t mo t po s run or strain or wee s his can strain our incision which can ead to a hernia amp es inc ude ut are not imited to roceries aundr n ants pets
o ot iv o s o ot iv ti yo o o p i m ic tio