After removal of the bladder of the patient is transferred to the intensive care unit, where he comes to his senses, and his condition is normal.
The postoperative period when cystectomy (patient care)
Pain or discomfort, doctors eliminate with medication. For many patients used an epidural, others - give medication as needed. In some cases, the patient is a long time in the intensive care unit.
For the patient after tsitektomii connected monitors, drainages. A sample list:
- Oxygen. oxygen supply lasts 1-2 days, depending on the condition of the person. A nurse checks the level of oxygen and vital signs every 4 hours.
- Nasogastric tube. It is placed during surgery through the nose into the stomach. With the help of a probe poured the contents of the stomach to heal and restore bowel. The probe is within 5-7 days. Sometimes there is pain in the throat, and dry mouth. At this time the patient not to eat or drink. The probe is removed when the bowel resumes.
- Central venous catheter. Intravenous infusion of nourishing the body during this period. Fluid flows into a large vein, often in the neck, the chest through a catheter. It is placed during surgery and used to drip, drug administration, blood transfusion, blood sampling.
- Patient controlled analgesia. A small pump (pump) with a supply of painkillers, prescribed by a doctor which is attached to a drip. The pump is adjusted so that the patient is feeling pain when he could press a button. For quick symptom relief a small amount of the drug enters the bloodstream.
- Sequential compression devices. The sleeve is placed around each leg. It is connected to a pump, which pumps air through a different portion of the sleeve, creating pressure around the calves. Pressure accelerates the movement of blood through the vessels, preventing blood clots. These devices are worn at night, during the day, except in cases when the patient leaves the bed and begins to walk.
- An incentive spirometer - a device to save the lung health after surgery. The nurse teaches how to use it. As a result, reducing the risk of lung infections, and / or shortness of breath.
- Hemovacs draining device accelerates wound healing by removing excess liquid. Drainage tube placed at the time of cystectomy, secured by stitches. Basically two tubes are used, which are removed prior to discharge.
Drinking plenty of fluids will be possible when the work of the intestine is restored. Earlier return to Eating and Drinking can lead to nausea and vomiting. intestinal bowel movement will be possible in a few days, when the body goes back to normal.
It is important to begin to sit up and walk the next day after surgery. This prevents serious complications - pneumonia, and blood clots in the legs. Nurses and therapists help patients.
Before discharge, the patient is prescribed analgesics and drugs for the prevention of constipation - a side effect of painkillers. Some patients require antibiotics.
Five days after surgery come histology results, the patient almost always is at this time in the hospital. On the basis of obtained results of further treatment options are discussed.
After 2-3 weeks after discharge, the patient visits the clinic for postoperative inspection. Even after surgery require monitoring on a regular basis to make sure that the disease does not return.
However, if the following symptoms occur, you must urgently seek medical advice:
- There was pain or swelling in the legs, sudden chest pain or shortness of breath.
- The incision site appeared redness, pain, feeling of heat.
- Severe nausea or vomiting.
Studies have shown that the use of certain herbs can cause complications in people after surgery. It is important to pay attention to the following plant species:
- Ginkgo biloba.
- St. John's wort.
- Vitamin E.
- With Palmetto.
Herbs can provide the following:
- modify or extend the effects of drugs used in anesthesia;
- affect bleeding or clotting;
- have an effect on blood pressure or interact with medications used during surgery.
In many cases, herbal remedies reception is better to stop for 2-3 weeks prior to surgery.
Possible complications after the removal of bladder cancer
This is a major operation. Of the following complications in the patient may not experience a single problem. You should know that all over the world when performing radical cystectomy there is a 60% probability that there will be one of the consequences of these below. Doctors Assuta Hospital shall make every effort to reduce the risk of complications.
The overall effects of the removal of the bladder in men and women:
- The large intestine is very slowly returning to normal after the surgery, which will require the temporary introduction of nasogastric tube. Sometimes it takes a few months.
- Loss of erectile function in men. Often during cystectomy remove the nerves that are needed for an erection.
- Dry ejaculation in men, which does not mean a loss of orgasm.
- Reducing the size of the vagina in women, making it difficult sexual intercourse. It reduces the likelihood of achieving orgasm.
- Cancer can not be cured only by removing the bladder.
- The development of infection in the gut or wound.
- Blood loss.
Rare complications after removal of bladder cancer:
- Problems with anesthesia, lungs and heart that will require staying in intensive care (respiratory tract infection, heart attack, stroke).
- Blood clots in the legs or lungs.
- Reduced liver function over time.
- Narrowing of the ureter to the junction with the intestine.
- Recurrence of cancer in the urethra saved.
- Increased content of acid in the blood that would require treatment.
- Deficiency of vitamins.
Very rare effects of surgery to remove the bladder:
- The need for another surgery.
- Leakage of urine.
- intestinal damage, major blood vessels and nerves.
- bowel injury requiring the creation of a workaround.
Rehabilitation after removal of the bladder
It is important to remain physically active even during the recovery. Daily walks will accelerate healing, reduce depression, enhance muscle tone. About six weeks is needed for complete healing of the operated area. During this period, it is contraindicated heavy and strenuous exercise, excessive stair climbing. It will be possible to drive a car 3-4 weeks after cystectomy if the patient feel good and do not take without a prescription any painkillers.
Is a special diet required after removal of the bladder?
Specific advice doctors give during discharge. Most patients return to normal diet. But experts advise to eat small and frequent meals and drink plenty of fluids.
What kind of help and support the patient can expect in the Assuta?
In the clinic, the patient will give the care instructions for catheters and stents. If you create a stoma nurse will conduct coaching and training.
Radical cystectomy and reconstructive surgery - a serious test. The clinic support is available to help a person cope with the situation, its impact on life. Psychologist - a part of a team of doctors, working with the patient.
Questions to the doctor
These questions are helpful when talking with a specialist about the disease - cancer of the bladder and radical cystectomy:
- After the operation, the treatment will be continued?
- What are the risks of surgery?
- Are there any side effects of surgery?
Recommendations for communication with the doctor
These tips will help you keep track of information that is discussed during the visits:
- You need to make a list of questions that the patient wants to ask a specialist.
- You can invite a friend or family member who will accompany the patient and provide moral support.
- Patient or attendant should take notes during a visit to the doctor.