After bladder cancer surgery
You will wake up with a few tubes in place, such as a drip, wound drain and catheter.
How long you stay in hospital depends on what operation you have. You might be in hospital for a week or 2. You will need to allow yourself time to recover when you get home.
When you wake up after your operation
After the operation, you wake up in the recovery room. You will have one to one nursing care. The nurse looks after you until you are awake and well enough to go back to the ward.
Everybody is different when they are waking up after an operation. It takes some people longer than others to wake up. Some people remain very sleepy for a while afterwards. You may be in the recovery room for hours before you are ready to go back to the ward.
Back on the ward your doctor will see you regularly. Specialist nurses may visit you. They look after people who have had major surgery but do not need to be in the intensive care or high dependency unit.
Sometimes you may wake up in the
(ICU) or (HDU) after your operation. This is so your doctors can keep a closer eye on you. This may happen if:
- your general health is poor
- the operation took longer than planned
- the operation was more complicated than the doctors thought it would be
In the ICU you have one to one nursing care. In the HDU you have very close nursing care.
The staff in the ICU or HDU will speak to a member of your family or friends about visitors. But, you usually move back to the ward within a day or so.
Drips and drains
To start with you might have a drip (intravenous infusion) into your arm until you're eating and drinking again.
When you wake up, you might have several different tubes in place. This can be a bit frightening. But it helps to know what they are all for. You might have:
- one or more thin tubes called wound drains in the operation area, to drain any fluid or blood that collects
- a tube down your nose into your stomach (nasogastric tube) to drain fluid and stop you feeling sick
- a bag or tube (catheter) draining urine
- thin tubes (ureteric stents) that drain the urine from your ureters
- a tube going into your back (epidural) or into the muscle near the wound to give painkillers
If you have a new bladder, you have a tube (catheter) into the new bladder to drain urine. Your nurse flushes the new bladder regularly to get rid of blood clots.
If you have a stoma, your nurse checks how much urine your new stoma is draining. Your nurse can gently flush the stoma out with water if it is blocked.
Painkillers
It’s normal to have some pain and feel sore for the first week or so. You have painkillers to help control this.
Tell your doctor or nurse if you feel pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly. Managing the pain well will help with your recovery. It will help you feel comfortable to move around and cough.
Immediately after surgery, you might have painkillers in one of the following ways:
- painkillers through a drip into the bloodstream - you control this by pressing a button when you have pain - this is called patient controlled analgesia (PCA)
- local anaesthetic through a small thin tube into your back (an epidural)
- an injection of anaesthetic into the nerves close to the area of surgery (a nerve block)
You get painkillers to take home. Follow the instructions your nurse and pharmacist gives you about how often and when to take them. Contact your doctor if you still have pain or if it gets worse.
Eating and drinking
Your nurse starts offering you sips of water within a few hours. If you can cope with these, you can gradually drink more and then try eating a light diet.
Gradually, you get back to normal over a few days. Your nurse might give you high protein, high calorie drinks to help maintain your nutrition. Once you are drinking plenty of fluids, your nurse takes your drip out.
Moving around
Once you have recovered a little from the anaesthetic, the nurses and physiotherapists help you to move around as soon as possible.
Even when you are still in bed, they help you to do deep breathing and leg exercises. These help stop you getting a chest infection or blood clots in your legs.
At first when you get up you might feel quite lightheaded and don’t feel like you have the strength to move around very far. This is because you’ve been in bed for a long time. It will get easier the more you do it and the more you gain strength after the operation.
Your wound
You have dressings over your wounds. After a couple of days, your nurse changes the dressings and cleans the wounds.
The size and number of your surgical wounds depend on whether you had open surgery or keyhole surgery. You’ll have several smaller wounds if you had keyhole surgery. You have at least one wound, a longer incision, with open surgery.
The wounds have stitches or clips. The stitches are usually dissolvable so don't need removing. The clips are not dissolvable and stay in for about 10 days. A nurse will take them out, this could be at home or you might need to go back to hospital.
Before you go home, your nurse gives you information about how to care for the wound.
Possible side effects
There is a risk of problems or complications after any operation. Many problems are minor but some can be life threatening. Treating them as soon as possible is important.
Passing urine
After surgery to remove your bladder, you will pass urine in a different way. Doctors call this urinary diversion. There are different types of urinary diversion. How you pass urine depends on what type of diversion you have.
Going home
You’ll need help when you first go home. You’re likely to feel very tired for several weeks and sometimes months after your surgery. It helps to do a bit more every day.
Try:
- sitting for less time each day
- walking around the house a bit more each day
- building up to walking outside
What you can do depends on how fit you were before your surgery and any problems you have afterwards. Talk to the physiotherapist or your doctor if you’re unsure about what you should be doing.
Contact your doctor or specialist nurse if you have any problems or symptoms you’re unsure about. You’ll have follow up appointments to check your recovery and fix any problems. They’re also your opportunity to raise any concerns you have.
If you have a urostomy
Your nurse will give you some urostomy bags to take home. They will tell you how to get the equipment you need when you are back home.
Your stoma nurse might visit you at home. Or you may have a district nurse visit instead. You will have phone numbers to contact for advice when you are sent home. Do ask for their help with any questions or difficulties you have.
Follow up
After having surgery, you have regular check ups to see how you are recovering. You first follow up is after a couple of weeks.
At the follow up appointment your surgeon:
- gives you the results of the surgery
- examines you
- asks you how you are and if you have had any problems
The appointment is also your chance to ask the doctor questions. It’s a good idea to write down any questions you have before your appointment, so you remember what you want to ask. Taking someone with you can help you to remember what the doctor says.
How often you have check ups after depends on the results of your surgery. Ask your doctor or specialist nurse how often you need to have check ups and what they will involve.
If you are worried about anything or notice any new symptoms between appointments, let your doctor or nurse know as soon as possible. You don’t have to wait until the next appointment.
