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Radical cystectomy with construction of Bricker bladder

Follow-up

Postoperative observations

  • Circulation in the stoma
  • Sutures, bandage, and skin around the stoma
  • Urine drainage
  • The vaccum drain can be removed as indicated by the surgeon
  • The pigtail catheters can be removed on the 10th postoperative day.
  • Sutures in the incision can be removed 12-14 days postoperatively (with the primary care doctor) 

Training 

On the second postoperative day, the patient's training on stoma care will be initiated. The patient should be trained every day or every other day according to the needs of the patient. The patient should be able to take care of the stoma alone upon discharge. Anbefalt kontrollregime

Recommended follow-up

The patient should have follow-up by a specialist 3 and 6 months after the surgery. Thereafter, checks should be with 6 month intervals over a period of 5 years. After 5 years, follow-up can be taken over by the primary care doctor.

Evaluation should include

  • Clinical examination with palpation of the abdomen and transrectal exploration
  • Blood tests: Hb, creatinine, ALP, venous acid-base test (should be followed closely for tendency of increasing creatinine), vitamin B12 (followed from 2 years) 
  • Thoracic X-ray (after 2 years x 1 annually)
  • CT urography should be performed after 3 months and 1 year. If these are satisfactory, CT urography should be performed later upon indication (hematuria, clinical UVI, flank pain). Somewhat more liberal CT urography is performed for Tis. For monitoring of hydronephrosis, ultrasound of the kidneys is an alternative.
  • Urine for cytology

 

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