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University Hospitals Seidman Cancer Center Center Lends Support to Ensure a Quicker, Safer Recovery

Patients may leave the hospital and return home once their pain is controlled exclusively by oral medication, their laboratory tests and vital signs are stable and they are eating a solid food diet. Most patients undergoing bladder cancer surgery typically have a 7- to 10-day hospital stay; however, each patient is different and is advised to go home only when ready.

The Urologic Oncology Center surgeon will schedule a follow-up appointment one to two weeks after surgery.

Following hospital discharge, a patient's diet is not advanced until bowel function returns, which can vary on an individual basis. If this function does not recover within one week, intravenous nutrition may be required.

A patient may also:

  • Receive instructions regarding when to resume taking blood-thinning medication.
  • Take pain medication prescribed at discharge. An over-the-counter stool softener should be taken by mouth twice daily. All narcotic pain medications are constipating and a stool softener will help to prevent this.
  • Patients should drink at least six to eight glasses of water a day.

Activity Level

UH Seidman Cancer Center team encourages patients to walk following surgery. This can be extremely beneficial to the healing process.

Patients are also advised about the following:

  • Do not sit in one place for longer than 45 minutes at a time.
  • Do not participate in biking, motorcycling, or horseback riding for four weeks following the surgical procedure.
  • Participate in as much walking and stair climbing as is tolerable. These activities can speed up the healing process.
  • Take a shower 48 hours following surgery.
  • Do not drive or lift over five pounds until the postoperative appointment.

Skin Care

  • Patients may have port sites, or small incisions where the surgery was performed, that are covered by Steri-Strips™ or a larger incision with staples that will be removed at the postoperative visit. Steri-Strips™ are small pieces of surgical tape that may be removed as early as 48 hours after surgery or they may stay in place until the patient’s follow-up appointment.
  • Once the patient's dressings are removed, it is not uncommon to have a very small amount of drainage from where the dressings were in place.
  • Patients may be discharged with a drain in place. Individuals will be given separate instructions regarding emptying, recording the amount of drainage and the care of the surgical drain.

Foley Catheter

Depending on the patient’s type of urinary diversion—ileal conduit, orthotropic neobladder or internal reservoir (also called an Indiana pouch)—a Foley catheter, abdominal drainage bag or other drains may be put into place during the surgical procedure. A catheter is a tube that carries urine from the bladder to the outside of the body and into a bag. This catheter typically stays in place until the amount of healing is sufficient.

When a patient goes home, the catheter should drain into a larger bag. When a patient travels away from home, he or she can wear a smaller bag, which is concealed under the pant leg. Patients will also receive instructions regarding the care of the catheter before discharge from the hospital.

It is completely normal for patients to experience some urine leakage around the catheter. Blood in the urine is also a common occurrence.

Problems that Patients May Experience at Home

  • Bruising around the incision sites: This is not uncommon and will improve over time.
  • Bloody drainage around the Foley catheter or in the urine: This is especially common after increasing physical activity or following a bowel movement. While blood drainage can be alarming, resting for a short period of time should improve the situation. Patients should call their UH Seidman Cancer Center surgeon if they see clots in the urine or if they have no urine output for one to two hours.
  • Abdominal distention, constipation or bloating: Patients should make sure that they are taking a stool softener as directed. If patients do not have a bowel movement within 24 hours following surgery, they should drink milk of magnesia as directed on the bottle. If after three doses of milk of magnesia patients still have no bowel movement, it is safe to use a Dulcolax® suppository.
  • Fever, chills, nausea, vomiting, bleeding and increased pain: These symptoms should not be ignored. Patients should contact the Urologic Oncology Center immediately should any of these problems arise:
    • A temperature over 102° F
    • Urine stops draining from the patient’s catheter into the drainage bag
    • Any pain so excruciating that medication is not helping to relieve it
    • Large amount of blood clots in urine
    • Bladder spasms that are not relieved with pain medication

The Follow-Up Visit

  • A follow-up appointment will be scheduled with the patient at UH Seidman Cancer Center one to two weeks after discharge.
  • Patients can eat, drink and take medications prior to the follow-up appointment.

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