If you have had your bladder removed, you know that it is a life-changing operation. Medically, we call this surgery a ``Cystectomy.`` Because the way you urinate is completely different after this operation, you will have to change some things in your daily life, such as how you bathe and how you travel. This change may affect the way you feel about your body, your relationships with others, and especially your sex life. But don't worry. With time, you can go back to doing everything you used to do. Even if you have to use an external bag to collect urine, you can go back to work, exercise, swim, and do all of these things. No one will even notice until you tell them about it.
How is your new 'Bathroom Routine'?
The way you urinate after surgery depends on the type of surgery you had. There are three main methods.
| Type of surgery | How it works | Things to watch out for |
|---|---|---|
| Conduit Urostomy | Urine from your kidneys is taken directly out of your body through a tube made from a part of your own small intestine. This tube is connected to a small opening (stoma) made in your abdomen, through which the urine is collected in a flat, adhesive pouch. | This bag needs to be emptied several times a day. |
| Neobladder Aka new bladder | This involves taking a large section of your small intestine and creating a kind of bladder inside your body. It is connected to your urethra, so you can urinate as before. | However, because there is no natural sensation of a full bladder, sometimes, especially at night, some urine may leak. This requires the use of a pad. Sometimes, a catheter may be inserted to completely empty the bladder. |
| Reservoir Internal urinary retention | Here, too, a portion of the intestine is used to create a pouch inside the abdomen to collect urine. This means you don't need to wear an external bag. | This bag must be emptied about 5-6 times a day using a catheter inserted through the stoma. Sometimes urine can leak from the stoma. If this happens, you may need to have another operation. |
How do you adapt to daily life?
First, give yourself time to get used to the change in your body. As you get used to it, your family and friends will get used to it too. If you have a urostomy pouch, these tips will help you a lot:
- Empty the bag when it's one-third full. Then you can store it flat, out of sight.
- Before flushing, put a piece of toilet paper in the toilet. This will stop the urine from leaking.
- After emptying, don't forget to close the spout of the bag properly.
- Change the bag in the morning before eating or drinking anything. That way, there will be less urine dripping.
- In the beginning, use a mirror to check if the bag is properly attached.
- If you are concerned about the odor that comes out when you empty the pouch, you can use special pouch deodorants.
How to protect the skin around the stoma?
If you have an external pouch, you need to take special care of the skin around your stoma. Otherwise, the area can become sore and red. To help prevent skin problems, do the following:
- When removing the bag, remove it slowly, so as not to damage the skin .
- Change the bag exactly as often as your doctor or nurse advises. Changing it too often, as well as changing it too late, can damage the skin.
- Don't use more tape than necessary.
- Measure the exact size of your stoma and cut the skin barrier to fit it.
What are the symptoms of an infection?
If you have a urinary tract infection, you may experience the following symptoms. Be aware of this.
- Dark or cloudy urine.
- More mucus than usual in the urine (it is normal for a small amount of white mucus to come out of the urethra).
- A strong, unpleasant odor from the urine.
- Back pain.
- Fever.
- Stomach upset and vomiting.
If you have one or more of these symptoms, it could be an infection, so be sure to let your doctor know.
If you have these symptoms, see a doctor immediately.
In addition to the usual symptoms of infection, if you have any of the following, seek medical advice immediately. If necessary, do not hesitate to go to the Emergency Department (ETU) of the nearest hospital.
- If bleeding from the stoma (opening) does not stop even after applying a little pressure.
- If you have severe stomach pain, cramping, or swelling .
- If your bag constantly leaks urine or if it is not properly attached.
- If the skin around the stoma continues to be red and sore .
- If the color of the stoma turns dark purple, brown, or black .
Can you bathe or swim?
Yes, no problem! A stoma is like a door that opens only in one direction. So no water can get in. You can shower or bathe with or without the pouch. But it is best not to use bath oils or soaps that contain moisturizers when bathing.
Swimming is not a problem either. But it's good to think about these things:
- Use a small bag or waterproof cover when swimming.
- Empty your bag before going into the water.
- Use waterproof tape around the edges of the bag.
- After putting on a new bag, wait a few hours and then go swimming.
Food, clothing, and work
Do you need to be careful about food and drink?
There is nothing to change in particular. But drink plenty of fluids, such as water . This is very important to reduce the risk of infection. Caffeine and alcohol are dehydrating, so it is best to limit them. Reduce your fluid intake close to bedtime. Also, wear a large bag (night drainage bag) to collect excess urine while you sleep.
Your bladder is designed to keep odors out. So you won't smell anything until you empty it. However, some foods and drinks can change the smell of your urine. For example: asparagus, coffee, fish, garlic, onions. Some medications and vitamins can also affect the smell of your urine.
Do you want to buy new clothes?
It may be easier to wear loose clothing at first. But after a while, you will be able to wear the same clothes you wore before. You should avoid things like belts and tight clothing that will be tight on the stoma area.
When are you going back to work?
Most people can return to work without any problems. However, because it takes time to heal after surgery, your doctor will tell you when you can return to work. If your job involves heavy lifting, tell your doctor. You may need to wear a special support belt (ostomy support belt).
Sex life and relationships
Removing your bladder can affect your sex life, especially if other organs were removed along with your bladder. Some changes are temporary, but others may not be. Talk to your doctor about this openly.
Sex can feel a little awkward at first. You may be afraid that your partner will hurt you, and you may also feel insecure. Start slowly and talk about your feelings. This can help ease the discomfort.
For the male side
If the bladder is removed because of cancer, the prostate and the tubes that carry sperm are usually also removed. So, although you may be able to have an orgasm, you will not be able to ejaculate. It is common to have nerve damage after surgery and have erectile dysfunction. There are various treatments for this, including medications, injections, and vacuum pumps. It can take up to a year for the nerves to heal, so don't rush into making any final decisions.
For the women's side
If the cancer has spread, the uterus, cervix, and part of the vagina may also need to be removed. If the ovaries are removed, menopause may occur. Vaginal dryness or narrowing may make sex difficult. Your doctor may recommend lubricants. Over time, you and your partner will adjust to this new situation and find new ways to enjoy sex.
Take-Home Message
- Having your bladder removed is a big change in your life. But don't worry, you can successfully adapt to this new life with time.
- Learn how to properly manage your urinary bag or internal retainer, depending on the type of surgery you had.
- Take great care of the skin around the stoma. Keep the area clean and dry.
- Be aware of signs of infection such as change in urine color, strong odor, and fever. If in doubt, see a doctor immediately.
- You may feel depressed with this change. That's normal. Talk about your feelings with family, friends, and your doctor. Seek counseling if necessary.
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න