What is included in postoperative care following partial cystectomy?

Updated: Apr 03, 2019
  • Author: E Jason Abel, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Answer

Placement of a drain in the perivesical space and maintaining a large caliber urethral catheter helps facilitate healing of the suture line where the bladder has been repaired. Ideally, the bladder is kept decompressed and any initial urine leakage is drained to allow healing of the bladder suture line. A urethral catheter also allows monitoring of urine output and detection of hematuria. This catheter is usually left in place for 7-14 days postoperatively. A cystogram may be obtained prior to catheter removal to ensure that the bladder suture line has healed.

Rarely, intravesical bleeding may result in urinary clot retention and may require gentle bladder irrigation to evacuate clots. Postoperative wound infection or abscesses may require open or percutaneous drainage. Ureteral obstruction should be suspected if the patient reports flank pain. IVP or ultrasonography can be used to confirm this diagnosis, and percutaneous nephrostomy may be used to temporarily divert urine in the hope that the obstruction is temporary. Incontinence due to altered bladder compliance and uninhibited bladder contractions usually improves with time and anticholinergic medications.


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