Navigating Life Post-bladder Removal - A Guide to Wellness

Introduction

Living without a bladder (spherical-shaped organ that holds urine) can be a significant adjustment, but with the right mindset and support, individuals can lead fulfilling lives. Whether an individual has undergone a cystectomy (bladder removal) due to cancer or other medical reasons, managing life after bladder removal requires adapting to new routines and embracing a holistic approach to well-being.

What Is Cystectomy?

A cystectomy is a surgical procedure that involves the removal of the urinary bladder. This procedure may be performed for various medical reasons, including bladder cancer, interstitial cystitis (a painful long-term bladder condition), or other conditions that significantly affect the bladder's function and health.

There are different types of cystectomies, each tailored to the specific needs of the patient and the underlying medical condition. The two primary types are:

• Partial Cystectomy: In this procedure, only a portion of the bladder is removed, typically when the cancer is limited to a specific area. This allows for the preservation of a functional part of the bladder.

• Radical Cystectomy: This extensive surgery involves the complete removal of the bladder. In males, this may also include removal of the prostate (walnut-shaped organ below the bladder), and in females, it may involve the removal of the uterus and part of the vagina.

• Ileal Conduit or Neobladder: After the removal of the bladder, the surgeon must create a new way for urine to exit the body. This can be achieved through different methods. In an ileal conduit, a piece of the small intestine is used to create a passageway for urine, which is then collected in an external bag. Alternatively, a neobladder may be created, allowing for the storage and elimination of urine in a more natural manner.

How Can Life Be Managed After Bladder Removal?

A step-wise guide to managing life and adjusting to daily routine after bladder removal involves the following approaches:

• Understanding the Changes: Recognizing the physical and emotional adjustments that come with bladder removal is the first step. Acknowledge the changes in urinary function, and be prepared for the emotional impact of this transformation.

• Choosing the Right Continence Option: Explore continence options that best suit the lifestyle. Some individuals may opt for an ileal conduit, where urine is diverted to an external bag, while others may choose a neobladder, which allows for more natural urine elimination. Understand the pros and cons of each option to make an informed decision.

• Adapting to New Routines: Establishing a consistent routine for emptying urinary pouches or using an external collection device is crucial. Working closely with healthcare professionals can help streamline this process and make it a seamless part of daily life.

• Nutrition and Hydration: Without a bladder, maintaining a healthy balance of fluids becomes essential. Avoid drinks that can irritate the urinary diversion system. Consult with a nutritionist to create a diet that supports overall health and addresses any specific concerns related to the surgery.

• Physical Activity: Staying active is crucial for overall well-being. Discuss appropriate exercise routines with the healthcare team, focusing on activities that promote cardiovascular health and strength without putting undue stress on the body.

• Emotional Well-Being: Coping with the emotional aspects of bladder removal is vital. Seek support from friends, family, or a mental health professional to navigate the emotional challenges that may arise. Support groups can also provide a sense of community with others who have undergone similar experiences.

• Self-Care: Self-care of the body is crucial to prevent any future complications associated with bladder removal. A few steps for self-care involve:

1. Follow a proper skincare routine: Use skin barrier repair cream to avoid skin irritation around the stoma (surgical opening made in the abdomen for removal of waste from the body from the bowel into a collection bag directly).

2. Try to wear loose clothing: Consider using ostomy wraps or bands to minimize any bulging and ensure stability. While adapting, it might be necessary to use forgo belts that exert pressure on the stoma or clothing that feels tight around it.

3. If one has any feeling of urge to urinate, empty the pouch as soon as possible without waiting for a long time. Try to empty the pouch every two to three hours.

• Adjusting to a Stoma: In some cases, a urinary diversion involves the creation of a stoma - a small opening on the abdomen through which urine is expelled. Learning to care for and live with a stoma is a key aspect of post-cystectomy (bladder removal) life. Consult with a healthcare professional for guidance on stoma care routines.

• Traveling With Confidence: With proper planning and organization, individuals without a bladder can travel comfortably. Ensure that all necessary supplies, medications, and information about medical facilities are at the destination.

• Regular Medical Check-Ups: Regular health check-ups and follow-ups with healthcare professionals are crucial to address any health concerns promptly. Healthcare professionals can make personalized treatment plans based on the individual patient needs.

• Educate Others: Raising awareness about life after bladder removal is essential to dispel myths and reduce stigma. Educating friends, family, and colleagues fosters understanding and empathy, creating a supportive environment for individuals navigating this unique journey.

What to Do if Any Infection Is Suspected?

In case any infection is suspected, visit the healthcare professionals immediately. If the following signs are noted, get prompt attention from healthcare professionals:

• Bleeding from the stoma persists despite applying slight pressure.

• When one experiences persistent pain, cramping, or swelling in the abdominal area.

• When the pouch consistently leaks or fails to stay securely in place.

• The skin surrounding the stoma becomes repeatedly red or develops sores.

• The stoma exhibits a discoloration, appearing dark purple, brown, or black.

Conclusion

In conclusion, embracing life after bladder removal involves a holistic approach that encompasses emotional resilience, physical adaptation, and a proactive mindset. Acknowledge and navigate the emotional challenges, work closely with healthcare professionals for physical rehabilitation, and explore the array of resources available to enhance daily life. It is advised to get regular medical check-ups to ensure necessary support and adjustments in the healthcare plan, fostering long-term well-being.