Hints For Talking With Your Doctor
These tips may help you keep track of the information you and your doctor talk about during your visits:
- Make a list of questions you want to ask your doctor before your appointment.
- Bring a friend or family member to sit with you while you talk with your doctor. Some people get very nervous when they visit their doctor. Sometimes you canât remember everything that you talk about with your doctor. A friend or family member can help you remember what you and your doctor talked about.
- You, or the person who goes with you, may want to take notes during your appointment.
- Ask your doctor to slow down if you need more time to write down your notes.
You may want to ask your doctor if you can use a tape recorder during your visit. Take notes from the tape after your visit is over. This way, you can review your talk with your doctor as many times as you want.
When Will I Have My First Follow
Even after surgery, you will need to be seen routinely in clinic to make sure the cancer has not returned or to arrange further treatments. Make sure you donât miss any follow-up appointments.
However, if you experience any of the following before your appointment, please call your surgeonâs office at any time. After hours you will be able to contact an on-call physician. Occasionally, you may need to be directed to the nearest emergency room.
- You notice any pain or swelling in your legs, sudden chest pain, or shortness of breath
- Expanding redness, tenderness, warmth, or swelling at the incision
- You develop a fever
What Is Bladder Surgery
Bladder surgery is the repair of the bladder through surgical means. In some cases, the bladder needs to be removed. In its place, surgeons reconstruct the bladder with intestinal tissue. Doctors sometimes recommend bladder surgery for urinary incontinence, bladder cancer, and cystocele. There are different types of bladder surgery, so the procedure one goes through depends on the type of surgery.
If a new bladder is needed, surgeons will remove a segment of the intestines and create a bladder from it and attach it to the ureters. The ureters are a duct through which urine travels from the kidneys to the bladder, or new bladder in this case. This bladder varies in size from a small pouch to the size of an original bladder. Many patients prefer this option because it allows the urine to exit their bodies in a way theyre used to rather than having to empty a bag. The other option is a leak proof bag that is connected to a tube, known as a stoma, and brought to the skin for collecting the urine. Patients can empty the bag as needed.
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What Happens After The Operation
After the operation, you will be taken to the recovery room until you are awake and stable. Any pain or discomfort will be relieved with medications. Many patients will have an epidural, while others will receive narcotics as needed. Some patients will need to stay in the Intensive Care Unit , while most will be transferred to a regular hospital room.
Depending on the specifics of your surgery, you may have a tube placed into your nose to decompress the stomach. You will be able to start drinking liquids when your intestines begin to recover. Intravenous fluids will provide nutrition in the meantime. Drinking and eating too soon may lead to nausea or vomiting. You will also not have a bowel movement for several days after surgery until the intestines recover.
It is important to sit up and walk starting as early as the day after surgery. This will help prevent serious complications such as pneumonia and blood clots to form in the legs. Nurses and physical therapists will assist you as needed.
When you go home, most patients will be prescribed medication for pain and medication to prevent constipation, a common side effect from pain medication. Some patients may be given antibiotics. Take these as directed.
It takes about 5 working days for the pathology to return. Generally you will still be in the hospital. If not, we will call you with the results. Based on the pathology, we may discuss with you future treatments that may be necessary.
Should I Be Careful With What I Eat Or Drink With A Urostomy
Go easy on beverages near bedtime, and attach a larger night drainage bag to hold more urine while you sleep.
Your pouch is odor-proof, so you wonât smell anything until you empty it. If your pee has a very strong odor, it could be a sign of an infection. But other things can affect the smell, too:
- Foods, like asparagus, coffee, fish, garlic, and onions
- Medicines, such as antibiotics
- Supplements, like vitamins
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Radiotherapy With A Radiosensitiser
Radiotherapy is given by a machine that beams the radiation at the bladder . Sessions are usually given on a daily basis for 5 days a week over the course of 4 to 7 weeks. Each session lasts for about 10 to 15 minutes.
A medicine called a radiosensitiser should also be given alongside radiotherapy for muscle-invasive bladder cancer. This medicine affects the cells of a tumour, to enhance the effect of radiotherapy. It has a much smaller effect on normal tissue.
As well as destroying cancerous cells, radiotherapy can also damage healthy cells, which means it can cause a number of side effects. These include:
- tightening of the vagina , which can make having sex painful
- erectile dysfunction
- difficulty passing urine
Most of these side effects should pass a few weeks after your treatment finishes, although there’s a small chance they’ll be permanent.
Having radiotherapy directed at your pelvis usually means you’ll be infertile .
After having radiotherapy for bladder cancer, you should be offered follow-up appointments every 3 months for the first 2 years, then every 6 months for the next 2 years, and every year after that. At these appointments, your bladder will be checked using a cystoscopy.
You may also be offered CT scans of your chest, abdomen and pelvis after 6 months, 1 year and 2 years. A CT scan of your urinary tract may be offered every year for 5 years.
Prevention Of Postoperative Ileus Nausea And Vomiting
Postoperative nausea and vomiting prophylaxis is indicated by opioid use, inhalation anesthetics, and nitrous oxide. Optimal management of fluid during surgery with esophageal Doppler has been reported to reduce PONV within 48 h after surgery . Prokinetic agents such as metoclopramide, antiemetics, dexamethasone, and propofol have been reported to prevent PONV . In addition, insertion of the ureter stent may prevent PONV during uretero-ileal anastomosis . After RC, ileus is one of the most common complications, and is the main cause of delayed discharge. Postoperative ileus can lead to an imbalance in the patientâs nutritional status, increase morbidity, and increase hospital stay . Chewing gum has been reported to help prevent ileus. It has been reported to reduce the first flatus time and shorten the first bowel movement time . Oral laxatives are also recommended for the early recovery of organs after surgery. Prophylactic oral laxatives can rapidly restore normal bowel movement postoperatively and shorten the time to first bowel movement . In addition, the administration of alvimopan, an opioid receptor antagonist, has been reported to facilitate early recovery of intestinal function after surgery and shorten the length of hospital stay . RARC is reported to restore bowel function faster than Open RC .
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Traditional Gallbladder Surgery Recovery Time
With traditional gallbladder surgery, the patient may be required to stay in the hospital for several days. This is to ensure the incision begins healing properly and to safeguard against infection. During this time the doctor and hospital staff will monitor your pain levels and adjust your pain killer accordingly.
Bladder Cancer Surgery Approaches
There are three different surgical approaches to treating bladder cancer. What type of procedure your healthcare team recommends will depend on the size and location of the tumor, the stage of the cancer and other considerations. The types of surgery include:
Transurethral resection of bladder tumor : Used as the initial diagnostic procedure in most people with bladder cancer, this procedure is also used as a treatment method for some early-stage small or superficial cancers that have not invaded the muscle of the bladder.
During the surgery, a thin, rigid tube equipped with a light and camera is inserted through the urethra and fed up into the bladder. Other instruments can also be passed through the cystoscope to help remove a tumor and control bleeding.
Partial cystectomy: Also called “bladder preservation surgery,” this procedure involves removing only part of the bladder. It is done infrequently and only in a few special situations, such as when the tumor is small or easy to access, if the tumor has not spread, or if the tumor invaded the muscular layer of the bladder, but in only one place. Since much of the bladder remains, reconstructive surgery is not required, though follow-up surgery may be needed to fully restore function.
In people with female anatomy, the uterus, fallopian tubes, and sometimes the ovaries and part of the vagina may also be removed. In people with male anatomy, the prostate, seminal vesicles, and part of the urethra may be removed.
How Turbt Is Done
This surgery is done using an instrument put in through your urethra, so it there’s no cutting into the abdomen . You’ll get either general anesthesia or regional anesthesia .
A type of thin, rigid cystoscope called a resectoscopeis put into your bladder through your urethra. The resectoscope has a wire loop at the end that’s used to remove any abnormal tissues or tumors. The removed tissue is sent to a lab for testing.
After the tumor is removed, more steps may be taken to try to ensure that the cancer has been completely destroyed. For instance, the tissue in the area where the tumor was may be burned while looking at it with the resectoscope. This is called fulguration. Cancer cells can also be destroyed using a high-energy laser through the resectoscope.
Transurethral Resection Of Bladder Tumor
A transurethral resection of bladder tumor or a transurethral resection is often used to find out if someone has bladder cancer and, if so, whether the cancer has spread into the muscle layer of the bladder wall.
TURBT is also the most common treatment for early-stage or superficial bladder cancers. Most patients have superficial cancer when they’re first diagnosed, so this is usually their first treatment. Sometimes, a second, more extensive TURBT is done to better ensure that all the cancer has been removed. The goal is to take out the cancer cells and nearby tissues down to the muscle layer of the bladder wall.
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What Goes Into A Prognosis
When figuring out your prognosis, your healthcare provider will consider all the things that could affect the cancer and its treatment. He or she will look at risk estimates about the exact type and stage of the cancer you have. These estimates are based on what results researchers have seen over many years in thousands of people with the same type and stage of cancer.
If your cancer is likely to respond well to treatment, your healthcare provider will say you have a favorable prognosis. This means youre expected to live many years and may even be cured. If your cancer is likely to be hard to control, your prognosis may be less favorable. The cancer may shorten your life. Its important to keep in mind that a prognosis states whats likely or probable. It’s not a prediction of what will definitely happen. No healthcare provider can be fully certain about an outcome.
Your prognosis depends mainly on:
The type and location of the cancer
The stage of the cancer
Your overall health
Your treatment decisions
Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel feels during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after an advanced cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, report that they are more satisfied with treatment, and they may live longer.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.
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What To Expect After Your Surgery
As you can see, radical cystectomy is very major surgery and youll have a lengthy recovery. Many parts of the body are affected during the surgery and need time to heal.
On average, your hospital stay will be 5 to 10 days. Walking starts the day after surgery. This helps the bowels to start working again. Remember, this is bowel surgery too, not just bladder surgery! Expect to be on a liquid diet for the first few days before solid foods are gradually introduced.
While in hospital, youll have a number of IV lines and tubes, depending on your type of surgery. These will provide pain control, urine drainage and drainage of excess fluid from the surgical site.
Milestones In My Recovery Process
As an example here are some of the milestones in my recovery process:
Surgery For Bladder Cancer
Doctors at NYU Langones Perlmutter Cancer Center often perform surgery to manage invasive bladder cancer, meaning cancer that has spread into the bladder muscle wall or the surrounding tissues and organs. The quality of bladder cancer surgery is paramount because it can have an impact on your lifespan and quality of life.
Our urologic surgeons are highly skilled at open surgery and minimally invasive techniques for performing bladder cancer surgery. We develop a treatment plan based on your unique needs with the goal of maintaining as much urinary and sexual function as possible after surgery. To help you recover, we provide follow-up care and support services, including nutrition counseling and physical rehabilitation.
Can I Travel With A Urostomy
Yes, it just takes a little planning. Make sure to take about double the supplies you think youâll need.
If youâre traveling by car:
- Have a good idea of where you may stop for bathroom breaks.
- Donât leave your supplies in a hot car — they could melt.
If youâre flying:
- Travel with a doctorâs note saying you have a urostomy. This can clear up any questions as you go through security.
- Ask airport screeners for privacy.
- Put your supplies in your carry-on bag.
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What Is Bladder Cancer Surgery
Bladder cancer surgery involves the removal of part or all of the bladder to eliminate a cancerous tumor. If the bladder is removed, surgery will also be done to provide a method for urine to be transported from the kidneys to outside the body.
The surgery is used primarily in adults and usually performed as a scheduled surgery after a number of other tests are done to look for any spread of the cancer.
What Was Your Turbt Experience Like
Best of luck to those of you just joining the club no one wants to join – but please let me know how your TURBT goes and any suggestions you may have to help others in the comments below, or with the community.
Editorâs Note: We are extremely saddened to say that on January 28, 2020, Jennifer Toth passed away. Jennifer was a passionate advocate for the bladder cancer community. She will be deeply missed.
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