A woman stands in front of a bladder diagram, surrounded by bubbles framing advice for surgery preparation.

Things I Wish I Knew Before Surgery: Preparing for a Cystectomy

After you and your medical team have determined that a radical cystectomy (RC) and ileal conduit (IC) is your best bladder cancer treatment option, preparation is invaluable. Having a surgery such as this can, without question, be stressful. Rest assured that many of us have been through the same procedures and are living a normal, active life. 

While there is definitely value in researching your cancer and treatments, too much information can add to your stress.

Start walking before surgery

Recovery from major surgery takes time. You will have good days and other days when your energy is non-existent. Pushing too hard for a fast recovery may do just the opposite and set you back. Being in good physical condition is beneficial. If you are not a regular walker, it is never too late to start walking so your legs and body are prepared for recovery. Walking is essential during recovery and will help your energy return, so start before surgery.

Preparing for your bladder removal

"Try on" a wafer and bag. If a stoma or wound care nurse is available in your area or someone you know who wears a bag, ask for a bag/wafer or 2 and try them out. Actually, seeing what this looks like and how it may fit on your body and underclothing will prepare you for later on. Also, it assists with determining where you would like your stoma.

While the surgeon has the final say, your input for placement is important.

Outies are easier

Speak with your stoma nurse and surgeon about an "outie" stoma versus an "innie," just like your belly button. Innies or stomas that are flush with your stomach or below can be a problem as the urine tends to go under the wafer versus directly into the bag. My stoma is about 1 inch long when emptying and 1/2 inch when not.

Trust me - this is something worth having a discussion about.

Packing for your cystectomy

Wear non-restrictive, comfortable clothing to the hospital and the same going home. Pack light. I suggest a light robe, slippers, toiletries, and possibly a phone, iPad, or laptop and chargers. I wore 2 hospital nightgowns - one with ties in front and one with ties in back - my entire stay. If you have a leak or other issue, the staff will change your gowns and clean things up. For the ride home, a small pillow between the seatbelt and your abdomen will make the ride easier.

Surgery can be exhausting

You may be exhausted, have a minimal appetite, and have some temporary tubes. You will have your urostomy bag and night bag. The medical staff will have you up and walking fairly quickly. Walking helps with healing and "get things moving," so to speak. Rest so your body can begin healing. Walk frequently and slowly build up your distance. Visitors can be tiring also, so consider limiting them at the hospital. Have them visit when you are home and join in a short walk.

Take some supplies home from the hospital

Accept any and all urostomy bags, supplies, and samples they will give you at the hospital. If they do not offer, ask for some before you are released. Also, the contact information of your stoma nurse is invaluable when you have a leak or other issue with your IC.

One day at a time

I hope you feel the relief I did when your cystectomy is over, and you are on the road to recovery. Take it day by day as you rebuild your strength. Preparing for a cystectomy and getting through it is not easy but probably not as difficult as you imagined. Take it day by day as you rebuild your strength.

Finally, be as prepared as you are comfortable with - and then let it go. Don't spend all day worrying about things you have no control over. Your end goal is to be cancer-free, and this surgery is essential to that goal.

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