Leaving The Hospital After Bladder Cancer Surgery: What Doctors Need To See First

Bladder cancer surgery is a major operation, and there are a few milestones your medical team will want you to hit before they sign off on you going home.

Mobility

Doctors want to know you can walk on your own (or with the support you’ll have at home) and perform everyday functions like getting in and out of bed.

“I need to know that when you get home, you can get in and out of bed, get to the bathroom, get to the kitchen, and get back to bed,” Dr. Pstuka explains.

Being able to perform these tasks independently tells your medical team you are more likely to be able to move around safely, albeit a bit slower early on, when you get back home.

Digestion

“One of the most common complications of a radical cystectomy, because it’s also a bowel operation, is that the gut kind of goes to sleep and then people can’t really eat because they feel nauseated [and] sometimes they throw up,” Dr. Psutka explains.

These symptoms happen in about one in five patients, she says, but they can also be very short-lived, lasting only about a day or so.

“A lot of patients will have a sort of yo-yo effect back and forth between constipation and diarrhea while their gut kind of normalizes,” Dr. Psutka adds.

Hydration

Dehydration is another common issue for patients after cystectomy.

“Dehydration is the number one reason why people wind up back in the hospital,” Dr. Psutka says.

Before you head home, you will need to show that you can drink enough fluids and stay hydrated without IV support.

Pain

Some pain is expected after cystectomy, but doctors will want it to be under control before sending you home.

“Your pain has to be under good control. We’re getting pretty good at doing that with minimal narcotics,” Dr. Psutka says. “We have what are called enhanced recovery after surgery protocols that allow us to control pain really well, but minimize narcotic use.”

Urination

After bladder removal, your body eliminates urine in a new way. This is called urinary diversion.

Before going home, you’ll need to feel comfortable with your new system, which could involve either an ostomy bag (ileal conduit) or a catheter (neobladder). About 70% of patients in the U.S. use the ileal conduit to redirect urine after bladder cancer surgery, Dr. Psutka says.

“If you have an ileal conduit … you’ve got to be able to change the appliance and that takes time to get used to,” she adds. “And if you have neobladder, most patients will go home with a catheter in it.”

Your Recovery Timeline

Doctors aim to get patients home rather than to rehab facilities whenever possible, Dr. Pstuka says.

“We are trying really hard not to send people to nursing facilities and short-term care facilities because we know people do better when they’re in the comfort of their own home,” she adds.

But going home doesn’t mean recovery is over. The first few weeks can be the toughest.

Patients might experience:

• Lower energy
• Reduced independence
• Discomfort
• Urinary issues
• GI issues

“The actual recovery for most people to kind of get back to normal, we’re talking about on average 12 weeks minimum,” Dr. Psutka adds. The recovery period may be longer for patients who are older or have other comorbidities.

Questions To Ask Your Doctor

• How long will I need to stay in the hospital after surgery?
• What can I do to prepare myself for a better/easier recovery?
• How will I be monitored after I leave the hospital?
• Is there anything I should avoid doing, eating, etc. while I am recovering?

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