Cystectomy with ileal conduit urinary diversion is a surgery to remove the bladder and redirect urine into a pouch worn on the abdomen. People who have cancer that has spread into the bladder muscle may need this surgery.
During this surgery, the ureters are attached to a piece of intestine. The other end of this piece of intestine is then attached to an opening (stoma) that is made on the lower right side of your abdomen. After you have this surgery, your urine will leave your body through the stoma and flow into a pouch.
Tell a health care provider about:
- Any allergies you have.
- All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
- Any problems you or family members have had with anesthetic medicines.
- Any blood disorders you have.
- Any surgeries you have had.
- Any medical conditions you have.
- Whether you are pregnant or may be pregnant.
- Allergic reactions to medicines.
- Damage to other structures or organs.
- Leaking urine or intestinal contents at the site of the new connection (anastomosis).
- Blocked bowels (bowel obstruction).
- Sexual problems, such as trouble getting an erection.
- A blood clot:
- That forms in a vein in your leg (deep vein thrombosis).
- That forms and travels to your lung (pulmonary embolism).
- Follow instructions from your health care provider about eating and drinking, which may include:
- Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.
- 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
- 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
- 6 hours before the procedure – stop drinking milk or drinks that contain milk.
- 2 hours before the procedure – stop drinking clear liquids.
- Ask your health care provider about:
- Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
- Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure unless directed by your health care provider.
- You may be given antibiotic medicine to help prevent infection.
- You may need to follow a certain diet and take medicine to clean out your bowels before surgery (bowel prep). Follow instructions from your health care provider about how and when to do this.
- Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
- Ask your health care provider how your surgical site will be marked or identified.
- You may have a urine test to make sure there are no bacteria in your urine.
- Plan to have someone take you home from the hospital or clinic.
What Happens During The Procedure?
- An IV tube will be inserted into one of your veins.
- You will be given a medicine to make you fall asleep (general anesthetic).
- The surgeon will make an incision from the area near your belly button down to the lowest part of your abdomen.
- The ends of your ureters that empty into your bladder will be separated from your bladder. Then the bladder will be removed.
- Other structures or organs may also be removed:
- If you are having this procedure to treat cancer, lymph nodes near your bladder may be removed.
- In men, the prostate gland and sperm sacs may be removed.
- In women, part of the vagina may be removed.
- In men and women, part of the urethra may be removed.
- Creating the ileal conduit:
- A part of your small intestine (ileum) will be cut out. This will be used to create a tunnel out of your body (ileal conduit) for urine to pass through.
- Your small intestine will be joined back together with stitches (sutures) or staples.
- The ileal conduit will be closed off at one end. Then the ends of the ureters will be sutured to it.
- The open end of the ileal conduit will be brought through an opening (stoma) that will be made in your abdomen. The conduit will be sutured to this opening with stitches that dissolve safely into your body.
- The surgeon will place two tubes (stents) through the ileal conduit and into the two ureters. This will keep them open.
- A urine collection bag (urostomy pouch) will be placed over the stoma.
- Completing the surgery
- Drainage tubes will be placed in your abdomen to drain blood or fluid that collects after surgery. These will be attached to collection bulbs.
- The surgeon will use staples or sutures to close the incision through which your bladder was removed. A bandage will be applied.
Post Procedure Care
- Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
- You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
- You will be urged to get up and walk around as soon as you can.
- You will have an IV tube for fluids and nutrition until you can eat and drink on your own.
- You will be given medicine for pain and medicine to keep you from getting infections and blood clots.
- You will be shown how to care for your stoma and urostomy pouch. Make sure that you understand what you need to do. Follow each step carefully.
This information is not intended to replace advice given to you by your health care provider.