You can basically be discharged ten days after total cystectomy. A common problem in the early postoperative period after ileal in situ cystectomy is urinary urgency and pain, which usually improves after a short period of time, while bleeding and leakage will be rare. For patients with a hanging urinary bag, although the urinary catheter (or fistula) is attached to the stomach, the chance of infection is actually low because the urine is sterile, so just pay attention to cleanliness; if an infection occurs and the fistula becomes red and breaks, you need to see the surgeon as soon as possible, and you can directly register with the urologist on duty that day, not necessarily your surgeon for treatment.
After total cystectomy, the review should be more frequent, once a month. First of all, ultrasound should be done to evaluate whether the tumor is recurring in other locations; and because of the change of urination, patients should also have renal function tests to see if there are abnormalities in creatinine and urea nitrogen, and urodynamic tests to see if urine retention and hydronephrosis are caused by poor urination. Especially for patients who have in situ bladder surgery, the bladder is made from ileum instead. Since the intestine does not have muscles and nerves related to urination, the new bladder will not produce urination and the active urination function is poor, and the intestinal cells have a secretory function and will secrete from time to time to make the urine contain some mucus, so urination is still a big problem for patients after ileal in situ bladder surgery. The most common post-operative complication is that patients do not have the habit of active urination, resulting in too much urine being stored, which can return to the kidneys and cause great damage to kidney function, resulting in severe hydronephrosis and even kidney failure over time. Therefore, patients must make a urination plan and develop the habit of actively urinating every two to three hours and going to the toilet even if they do not feel like it. Urination requires force through the abdominal wall to squeeze urine out of the new bladder. This operation is not difficult to learn, and bedside doctors and nurses will train patients and family members after removing the ureter; if it still does not come out, consider inserting a catheter to assist in urination.