Before your operation for invasive bladder cancer

You and your family need to understand exactly what the operation involves and how you will manage afterwards. If you are going to have a urostomy or continent urinary diversion, you may see a stoma nurse. Stoma nurses are experienced in looking after stomas and teaching you how to do this yourself. They may visit you before and after your operation to help you learn to look after your stoma. Or the nurses on the ward will show you.

You might also see a stoma nurse if you are having a bladder reconstruction. This is in case the surgeon can't make a new bladder and has to carry out a urostomy instead.

At the first visit the nurse will answer your questions and show you the different types of urostomy bags you can use. They may give you a practice kit with a stick on stoma. You can practice sticking on the stoma bags and changing them. Your nurse will also explain how you can put thin tubes into the urostomy to drain out the urine (self catheterisation) if you will need to do this. 

It may be useful to have someone else with you when you talk to the stoma nurse. It might also help if your partner or someone else close to you understands what the operation involves and how you will need to manage afterwards.

You may also have a visit from someone who has already had the type of operation you are going to have. Most people find this extremely helpful. Someone who has been through what you are experiencing will know what is most important to tell you. And they will be able to answer your questions from first hand experience.

You will have blood tests to see how your kidneys are working. And you will also have blood tests to match your blood for any transfusions you may need during the surgery. You may have a chest X-ray to check your lungs before your anaesthetic. If you have any other possible health problems, you may have other tests to make sure that you are fit enough for the operation.

Unless you have a partial cystectomy, the surgeon will use part of your bowel to create a new way of getting rid of your urine. You may be asked to follow a special diet for a few days before your surgery to reduce the amount of stool in the bowel. You may also have a laxative to take each day for two or three days to empty the bowel and reduce the chance of infection. In some hospitals you will also have enemas to empty the bowel completely.

To help stop infection after surgery you will be given antibiotics before the operation. You may have the antibiotics as an injection or as tablets.

When you are in bed after an operation and not moving around very much, you are more likely to develop blood clots. To stop blood clots forming, you may have injections of blood thinning drugs such as heparin, tinzaparin, enoxaparin, clexane or dalteparin before the surgery and for a couple of weeks afterwards. 

The drugs stop the blood from clotting so easily. You usually have them as a small injection under the skin. You may need to have blood tests to check your blood clotting times. Your nurse or physiotherapist will also show you leg exercises that you can do after the surgery to lower the risk of blood clots. You may also be given compression stockings to wear.