You will have a few tubes in place when you wake up, such as a drip, wound drain and catheter. How long you stay in hospital depends on what operation you have, but you might be in hospital for a week or 2.
When you wake up after your operation
After a big operation, you wake up in the intensive care unit or a high dependency recovery unit. You usually move back to the ward within a day or so.
In intensive care you have one to one nursing care. In the high dependency unit you have very close nursing care. Your surgeon and anaesthetist review you regularly and watch your progress closely.
These units are busy and often noisy places that some people find strange and disorientating. You'll feel drowsy because of the anaesthetic and painkillers.
Drips and drains
To start with you might have a drip (intravenous infusion) into your arm until you're eating and drinking again.
When you wake up, you might have several different tubes in place. This can be a bit frightening. But it helps to know what they are all for. You might have:
- one or more thin tubes called wound drains in the operation area, to drain any fluid or blood that collects
- a tube down your nose into your stomach (nasogastric tube) to drain fluid and stop you feeling sick
- a bag or tube draining urine from your new stoma, if you have one
- a tube going into your back (epidural) or into the muscle near the wound to give painkillers
You have a tube (catheter) into the new bladder to drain urine. Your nurse flushes the new bladder regularly to get rid of blood clots.
Your nurse checks how much urine your new stoma is draining, if you have one. Your nurse can gently flush the stoma out with water if it is blocked.
It’s normal to have a little pain and feel sore for the first week or so. You have painkillers to help control this.
Tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.
Immediately after surgery, you might have painkillers in one of the following ways:
- continuous painkillers through a drip into the bloodstream - you control this by pressing a button when you have pain - this is called patient controlled analgesia (PCA)
- local anaesthetic through a small thin tube into your back (an epidural)
- an injection of anaesthetic into the nerves close to the lung (a nerve block)
You get painkillers to take home. Follow the instructions your nurse and pharmacist gives you about how often and when to take them. Contact your doctor if you still have pain or if it gets worse.
Eating and drinking
Your nurse starts offering you sips of water within a few hours. If you can cope with these, you can gradually drink more and then try eating a light diet.
Gradually, you get back to normal over a few days. Your nurse might give you high protein, high calorie drinks to help maintain your nutrition. Once you are drinking plenty of fluids, your nurse takes your drip out.
Once you have recovered a little from the anaesthetic, the nurses and physiotherapists help you to move around as soon as possible.
Even when you are still in bed, they help you to do deep breathing and leg exercises. These help stop you getting a chest infection or blood clots in your legs.
At first when you get up you might feel quite light headed and don’t feel like you have the strength to move around very far. This is because you’ve been in bed for a long time. It will get easier the more you do it and the more you gain strength after the operation.
You have dressings over your wounds. After a couple of days, your nurse changes the dressings and cleans the wounds.
The size and number of your surgical wounds depend on whether you had open surgery or keyhole surgery. You’ll have several smaller wounds if you had keyhole surgery. You have at least one wound, a longer incision, with open surgery.
The wounds have stitches or clips. The stitches are usually dissolvable so don't need removing. The clips are not dissolvable and stay in for about 10 days. A nurse will take them out, this could be at home or you might need to go back to hospital.
Before you go home, your nurse gives you information about how to care for the wound.
Possible side effects
After surgery to have your bladder removed, you normally pass urine in a different way. How you do this depends on the surgery you have had.
Some people leak some urine after a bladder reconstruction, particularly at night. Your surgeon and specialist nurse talk to you about how common this is, whether it is likely in your case and what to do about it if it happens.
Sex life and fertility
Men might not be able to get an erection after surgery. The nerves that control erections can be damaged during the operation. Sometimes your surgeon might be able to preserve these nerves so you can still get an erection.
After having your prostate gland removed during surgery, you can no longer father a child. Even if you can get an erection, you cannot ejaculate as you did before.
Women might have to have their vagina shortened when their bladder is removed. Your surgeon tries to avoid this as far as possible. You might also have your womb removed during surgery. This means you can’t have children.
Coping after surgery
Coping after surgery for bladder cancer can be difficult. You can call the Cancer Research UK nurses on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday, to talk things through.
Other people that may be useful to contact for advice and support are your:
- specialist nurse or stoma nurse
- surgeon or doctor
It may also help to talk to a close member of your family or a friend about your concerns.
After having surgery, you have regular check ups to see how you are recovering. You first follow up is after a couple of weeks.
At the follow up appointment your surgeon:
- gives you the results of the surgery
- examines you
- asks you how you are and if you have had any problems
The appointment is also your chance to ask the doctor questions. It’s a good idea to write down any questions you have before your appointment, so you remember what you want to ask. Taking someone with you can help you to remember what the doctor says.
How often you have check ups after depends on the results of your surgery. Ask your doctor or specialist nurse how often you need to have check ups and what they will involve.
If you are worried about anything or notice any new symptoms between appointments, let your doctor or nurse know as soon as possible. You don’t have to wait until the next appointment.