Before your bladder cancer surgery
Before surgery, you have tests to check your fitness and you meet members of your treatment team. This pre-op assessment usually happens a couple of weeks or a few days before your operation. Then you usually go into hospital on the morning of your operation, or the day before.
Most people are in hospital for around 1 to 2 weeks. The length of your stay depends on the type of operation you have and your recovery.
Tests to check you are fit for surgery
You have tests before your operation to check:
- your fitness for an anaesthetic, if you need one
- that you’ll make a good recovery from surgery
You might have some or all of the following tests:
- blood tests to check your general health and how well your kidneys are working
- a swab test to rule out some infections
- an
ECG 
to check that your heart is healthy - breathing tests (called lung function tests)
- an
echocardiogram - a chest x-ray to check that your lungs are healthy
- a cardio pulmonary exercise test (which checks your heart and lung function when you're resting and exercising)
You also have a blood test to match your blood for any transfusions you might need during your surgery.
Pre assessment clinic
One or two weeks before your surgery you have an appointment at the hospital pre assessment clinic.
Your pre assessment appointment prepares you for your operation. You meet members of your treatment team at this appointment.
The doctor or nurse will tell you what to do on the day of your operation. This includes instructions about when to stop eating and drinking, and whether to stop taking any of your medicines. Do not stop taking your regular medicines unless the doctor tells you to.
Your doctor or nurse might also talk to you about the Enhanced Recovery Programme at your hospital. This is a programme of care that helps people recover more quickly after a big operation.
Ask lots of questions. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.
You can ask more questions when you go into hospital on the day so don’t worry if you forget to ask some.
Before your operation you'll meet:
The surgeon
Your surgeon will tell you about:
- the operation you are going to have
- the benefits of having surgery
- the possible risks
- what to expect afterwards
They'll also ask you to sign a consent form to agree to the operation, once they know you understand what's involved.
The anaesthetist
The anaesthetist looks after you during the operation and gives you medicine (anaesthetic) that gets you to sleep. They also make sure you’re fit enough to have the surgery.
The nurse
The nurse checks your:
- general health
- weight
- blood pressure
- heart rate (pulse)
- temperature
- breathing rate (respiration)
The nurse looks after you straight after surgery and until you’re ready to home. They also check what help and support you have and find out what's needed when you go home.
Other people you might meet
There are other members of the healthcare team you might meet. This depends on:
- the operation you're having
- your general health before you go for your operation
The dietitian
The dietitian gives you help and advice about managing your diet. They might:
- help you get as well as possible before your operation
- explain how the surgery affects your diet
- give useful tips on how to increase your nutrients and calories
Your dietician might give you nutritional supplement drinks before surgery. Or you may need it after surgery.
Some people need a feeding tube in their stomach or small bowel. This makes sure you get the nutrition you need before and after your surgery.
The physiotherapist
The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery. They’ll also make sure you are safe to go home and get around. They can see if you need anything to help getting around easier like a walking frame for instance.
To help with recovery they might also teach you leg and breathing exercises to do after your operation. Learning how to do the exercises beforehand makes it easier afterwards.
The stoma nurse
You might see a stoma nurse if you are having a:
- urostomy
- continent urinary diversion
- bladder reconstruction, in case your surgeon is unable to make a new bladder
Stoma nurses are experienced in looking after stomas. They help show you how to look after your stoma.
Preparing your bowel for the operation
You might need to follow a special diet for a few days before your surgery. This special diet reduces the amount of stool (poo) in the bowel.
You might have some liquid (enema) gently put into your back passage (rectum). This empties the bowel completely.
Learning breathing and leg exercises
Breathing exercises help to stop you from getting a chest infection after surgery. If you smoke, it helps if you can stop at least a few weeks before your operation.
Leg exercises help to stop blood clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections under the skin.
You start the injections after your operation. You might also wear compression stockings and pumps on your calves or feet to help the circulation.
Your nurse and physiotherapist will get you up out of bed quite quickly after your surgery. This is to help prevent chest infections and blood clots forming.
This 3-minute video shows you how to do the breathing and leg exercises.
Breathing and circulation exercises after surgery
These exercises help prevent you developing a chest infection or blood clots in your legs after surgery. These problems are more likely when you are not moving around as you would normally.
You can do these breathing exercises while sitting up in a chair or in a bed or whilst lying down.
Relax your shoulders and upper chest.
Take a slow, deep, comfortable breath in and hold for a couple of seconds, then slowly breathe out.
Repeat this 3 times.
You can start these breathing exercises as soon as you come round from your anaesthetic.
You should try to do them every hour when awake until you are fully mobile.
If you need to cough, support your wound with your arms, a pillow or a rolled up towel.
If you are struggling to clear any phlegm, try a huff. This is where you breathe out in a short, sharp manner as if you were trying to steam up a mirror.
You should move about as soon as possible after your operation. But while you are not as mobile, try to keep your legs moving to encourage better circulation.
You can do these exercises in a bed or in a chair.
One foot at a time point your toes away from you then pull your toes towards your chin.
Try to do 10 of these on both feet at least 2-3 times an hour.
The next exercise is circling your ankles. One at time circle your ankles, clockwise and then anticlockwise. Repeat this 10 times with each ankle 2-3 times an hour.
Eating and drinking
You can usually drink clear fluids until 2 hours or so before the surgery. They might also give you high protein, high calorie drinks to have each day. These can help maintain your nutrition and help you recover more quickly after the operation.
You usually have to stop eating at least 6 hours before your operation. They may even tell you to not eat anything from the night before your operation.
Follow the instructions given to you by your team of when to stop eating and drinking.
Preventing infection
It’s likely you will have antibiotics before the operation to help stop infection. You have the antibiotics as an injection or as tablets.
Before you go into hospital
It’s worth sorting out a few things before you go into hospital. These might include:
- taking time off work
- care for children or other loved ones
- care for your pets
- care for your house
- cancelling your milk or newspapers
What to take with you
Take in:
- nightgowns or pyjamas
- underwear
- dressing gown
- slippers
- contact lenses, solution, glasses and a case
- wash bag with soap, a flannel or sponge, toothbrush and toothpaste etc
- sanitary wear or tampons
- towel
- small amount of money
- medicines you normally take
- magazines, books, playing cards
- headphones and music to listen to
- a tablet or smartphone for web browsing, entertainment and phone calls
- chargers for electronic devices
- a copy of your last clinic letter (if you have one)
Family and friends
Before you go into hospital, it might be worth checking:
- whether the ward is allowing visitors
- if they have set visiting times
- the best number for friends and family to phone, to find out how you are
The letter you receive before your operation may contain this information. But if not, you can phone the ward or hospital reception to find out.
You can use your mobile phone in hospital. But there may be some time before and after your operation when you won’t have your mobile nearby. And you may not feel like talking.
