This handout will tell you how to get ready for a radical cystectomy. It will also tell you how to
care for yourself at home after surgery and about follow-up visits to the Urology Clinic. Your
nurse will go over this information with you. Please feel free to ask questions.
What is Radical Cystectomy?
Radical Cystectomy is the surgical removal of the bladder. The prostate gland is also removed in
men. The uterus is also removed in women.
How do I get rid of urine after the bladder is removed?
After the bladder is removed, a urinary diversion is made using a piece of your bowel. This can
be done in different ways depending on your medical history, age, lifestyle, and how able you are
to care for yourself after surgery:
Neobladder: Continent urine reservoir made from piece of bowel and attached to the neck
of your urethra (urine channel). This allows you to urinate much like you did before your
surgery. You will not have a stoma if you have a neobladder.
Indiana Pouch: Continent urine reservoir made from part of your bowel to store urine. The
end of the pouch is then brought out through an opening on the abdominal wall and a stoma
is created. Using a catheter, you drain out the urine through the stoma at specific times.
Ileal Loop: Using part of your bowel as a loop/conduit, the ureters (two tubes that carry
urine from the kidneys) are attached so that they empty through this loop. The other end of
the loop is then brought out through the abdominal wall and a stoma is created. You will
need to wear a bag over your stoma to collect urine all the time.
Getting rid of stool from the bowel will reduce the risk of infection during surgery. The nurse
will give you information on how to do the bowel prep.
What to Expect after Surgery
You will be in the hospital for 7 to 10 days
You will have an intravenous line (IV) to give you fluids.
You will have one or two drains on either side of your suture line to collect fluid.
You may have oxygen.
NG Tube: A tube in your nose going to your stomach to help prevent nausea and vomiting
until your bowel starts to work again (about 3-5 days). You will not eat or drink anything
by mouth while the tube is in place or for one day after the tube is removed.
A Foley catheter may be placed in the space where your bladder was. It is taken out when
drainage stops, usually about 3 days after surgery.
You will have two small tubes, called stents, which go through your stoma into the newly
created urine reservoir and up the ureters into your kidneys. The stents help to drain urine
while the reservoir is healing. They are connected to a drainage bag at the side of your bed.
You will go home with the stents in place. They will be taken out when you come for your
first clinic visit.
You may have leg wraps, called Venodynes that will be on your legs when you are in bed.
These help prevent blood clots in your legs. They are removed when you are up walking.
You will be up walking the day after surgery. You should walk in the hall 3-4 times a day.
Getting up and walking early are the best ways to speed up your recovery. Walking also
helps to prevent complications such as bowel obstruction, pneumonia and blood clots. Pain
medicine will make it easier for you to move around.
Your incision will be held together with staples, and these will be taken out 7-10 days after
surgery. You may have a small amount of drainage from your incision. It will be cleaned
and the dressing changed daily and as needed.
While you are in the hospital, the ostomy nurse and the staff nurses will teach you how to
care for your stoma, pouch and tubes.
Your Care at Home
If you have the Indiana pouch, wash the stoma daily with warm water. If it is not covered
with a bag, you may cover it with a small gauze dressing.
If you have the Ileal loop, you should empty the bag every 2 to 4 hours or when it is one-
third or one-half full.
You may shower or take sponge baths. Do not take tub baths.
Drink at least 6 – 8 glasses of fluids per day.
You may drive after 2-3 weeks.
No straining or lifting over 10 pounds (1 gallon of milk) for 4-6 weeks after surgery.
Avoid contact sports for 4 to 6 weeks, or until your doctor tells you it is ok.
You may resume sexual activity as soon as you are physically and emotionally able to do so.
Plan on being off work for 4-8 weeks.
When to Call the Doctor
You should call your doctor if you have any of the following symptoms:
Shortness of breath or chest pain, call 911
Fever over 100.5° F
Shaking chills or sweating
Not making urine
Pink, red, cloudy and/or foul-smelling urine
Bloody discharge from your stoma
Redness, warmth, swelling or pus-like drainage at suture line
Loss of appetite
Nausea and vomiting
Diarrhea that lasts more than a few days
Belly, back or flank pain
Stoma looks darker or bluish-purple in color
Leg swelling or calf tenderness
Follow-Up and Clinic Visit
Your first appointment will be scheduled for you before you leave the hospital. Please call your
nurse or doctor with any questions or concerns.
We recommend that you have and wear a Medic-Alert bracelet or necklace.
Urology Clinic Nursing Staff: (608) 263-4757 - This is a 24 hour number.
Your Urologist, Dr._______________________________at (608) ____________________
If you live out of the area, call toll free, 1-800-323-8942.
Your medical record number ______________________________________
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright ©9/2015. University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#5639