Cystectomy With Continent Reservoir: Before Your Surgery

What is a cystectomy with continent reservoir?

A cystectomy is surgery to remove part or all of your bladder. Sometimes other organs, lymph nodes, and part of the urethra are also removed. The urethra is a tube that carries urine from your bladder to outside your body.

To do the surgery, your doctor makes a cut in your lower belly. This cut is called an incision. If the doctor takes out all of your bladder, he or she will need to make a new way for you to pass urine. This is called a continent reservoir. It's a storage pouch that attaches inside your pelvis. It's made from a piece of your bowel. There are two types.

• A bladder substitution reservoir is used if your urethra is not removed. It's also called a neobladder. One end connects to your ureters. These are the tubes that carry urine from the kidneys to the bladder. The other connects to your urethra. With this type, you can urinate much as you did before surgery.
• A continent diversion reservoir with stoma is used if all or part of your urethra is removed. It's also called a urostomy. One end connects to your ureters. The other connects to an opening the doctor makes in your belly. This opening is called a stoma. When you want to urinate, you put a thin plastic tube through the stoma. The tube is called a catheter.

In the hospital, a nurse with special training will teach you how to care for your reservoir. Most people go home in 1 to 2 weeks. But you will probably need 6 to 8 weeks to get back to your usual routine. If your surgery was done to treat bladder cancer, you may need other treatments. These include chemotherapy and radiation therapy.

Surgery to remove your bladder may affect your sexual or reproductive life. If a woman also has her uterus and ovaries removed, she will not be able to get pregnant. She could also start menopause and have hot flashes or other symptoms of menopause. And if a man has his prostate gland and seminal vesicles removed, he may have problems getting an erection. He will also not be able to get a woman pregnant. If you are a man who may want to father a child in the future, talk to your doctor. There are ways to save your sperm before the surgery.

It's common to feel sad or worried about how this surgery will affect you. It may help to join a support group. You can ask your doctor about these groups. You can also call the American Cancer Society (1-800-227-2345) for more information. Or you can visit its website at www.cancer.org.

What happens on the day of surgery?

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  Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
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  Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
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  Do not shave the surgical site yourself.
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  Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

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  Bring a picture ID.
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  The area for surgery is often marked to make sure there are no errors.
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  You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
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  The surgery will take about 3 to 6 hours.
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  You may have a thin plastic tube coming out of your urethra. This is used to drain fluids that can build up in the pelvis after surgery. It will be removed in a few days.
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  If you have a continent diversion reservoir with stoma, you may have a small plastic tube coming out of your stoma. It helps drain urine into a small bag until your new bladder heals.
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  If you have a neobladder, you may have drains in your belly for extra fluids. You may have a catheter coming out of your belly to drain urine from your new bladder into a small plastic bag.