Problems That Can Happen After Radical Cystectomy

If you have bladder cancer or cancer that has spread from other areas into your bladder, you may need a radical cystectomy.

Like all surgeries, radical cystectomy can cause further health problems. Knowing the signs and symptoms of possible complications after this procedure can help you get the care you need.

What is a radical cystectomy?

Radical cystectomy is a type of surgery where doctors remove your bladder and surrounding lymph nodes. For men, it also involves removing the prostate and seminal vesicles. Women will often have their uterus, ovaries, fallopian tubes, cervix, and part of their vagina removed.1,2

Your surgeon will then use part of your intestine to rebuild the urinary tract, which will allow you to urinate.2

What are the possible complications of a radical cystectomy?

A radical cystectomy is complicated since your surgeon will need to move several organs in your belly around to remove your bladder. This can leave you vulnerable to further health problems.2

Research shows it is common to have complications after the procedure. As many as 50 percent of all people who undergo a radical cystectomy will have additional health problems. While most are not serious, it is possible to have a major complication. Complications of the procedure include:2,3

  • Bleeding
  • Blood clots in your legs or lungs
  • Heart attack or stroke
  • Surgical incision infection
  • Lung infection (pneumonia)
  • Lung collapse
  • Pus or fluid inside the belly
  • Bowel problems (blockage of the small intestine, bowel leak, fistula, rectal injury)
  • Urinary problems (urinary tract infection, kidney infection or failure, urine leak, fistula, narrowing of the urethra)
  • Erectile dysfunction in men
  • Changes in arousal and orgasm in women
  • Nerve injury
  • Build up of lymph fluid
  • Dehydration or electrolyte changes
  • Death (this is uncommon)

Some of these complications are dangerous and may require more surgery or a hospital stay. Talk to your doctor about the possible risks of a radical cystectomy.2

After surgery

After a radical cystectomy, you will stay in the hospital for 5 to 10 days to begin the healing process. You will not be able to eat or drink right away. Instead, you will be started on fluids through an IV to prevent stomach problems. If you drink or eat too soon after surgery, you may feel sick to your stomach and throw up. It is also normal to go without a bowel movement in the days after a radical cystectomy. This is because your intestines need time to heal.1

Your healthcare team will want you to get out of bed and start walking soon after surgery, possibly even the day after. This is to help avoid pneumonia and blood clots in your legs, which are both life-threatening complications.1

After you leave the hospital

Once you go home after surgery, you will still need to take care to avoid further health issues. Continue to walk every day, but avoid exercise that wears you out. Also, avoid lifting anything heavy or climbing stairs for 6 weeks after surgery.1

You should be able to return to your normal diet at home, but it will take time for your intestines to fully recover. In the meantime, drink lots of water and eat several smaller meals throughout the day instead of a few large ones.1

Call your doctor right away or go to the hospital if you notice any of these problems:1

  1. Leg pain or swelling
  2. Chest pain that comes on quickly
  3. Trouble breathing
  4. Changes to your surgical incision (color changes, pain, warmth, or swelling)
  5. Fever
  6. Feeling sick to your stomach or throwing up
  7. Blocked catheter

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