Bladder cancer

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Side effects of surgery for bladder cancer

Side effects can happen with any type of treatment for bladder cancer, but everyone’s experience is different. Some people have many side effects. Others have few or none at all.

Side effects can develop any time during, immediately after or a few days or weeks after surgery. Sometimes late side effects develop months or years after surgery. Most side effects will go away on their own or can be treated, but some may last a long time or become permanent.

Side effects of surgery will depend mainly on:

  • the type of surgery
  • your overall health
  • the effect of other treatments (for example, tissue treated with radiation may not heal well after surgery)

Tell your healthcare team if you have these side effects or others you think might be from your surgery. The sooner they are aware of any problems, the sooner they can suggest ways to help you deal with them.

Pain

Pain often occurs after surgery because of trauma to the tissue. It may take time for the pain to go away after surgery, depending on the procedure and how well you heal and cope with pain.

Your healthcare team will prescribe pain-relieving medicines to control pain. Tell them if the pain doesn’t go away or pain medicines do not relieve the pain.

Find out more about pain.

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Nausea and vomiting

Nausea and vomiting can occur because of the effects of general anesthetics used during surgery. You may be given medicines to prevent and control nausea and vomiting. They are usually temporary side effects and often go away a few days after surgery.

Find out more about nausea and vomiting.

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Bleeding

Bleeding, or hemorrhage, can occur if a blood vessel is not sealed off during surgery or if you have a blood clotting disorder. The nursing staff will check your bandages and drains to look for any bleeding right after your surgery. If you have serious bleeding, your surgeon may have to take you back to the operating room to find where the bleeding is coming from and stop it.

A small amount of bloody drainage is normal after surgery. Tell your healthcare team if you see large amounts of blood.

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Urinary tract problems

Different problems with the urinary tract can develop after surgery for bladder cancer.

Certain anesthetics or pain-relieving medicines can sometimes cause an inability to urinate. For a short time after surgery, the healthcare team will monitor when and how much you urinate.

Repeated transurethral resections (TURs) can scar the bladder so that it loses the ability to hold urine. This scarring can make you urinate more often or lose bladder control (called urinary incontinence).

A partial cystectomy reduces the size of the bladder. This can make a person urinate more often.

Incontinence, blockage (obstruction) of the ureters and backflow (reflux) of urine into the ureters can occur after a radical cystectomy and reconstructive surgery. Sometimes people with neobladders need to drain the urine with a tube, or catheter, because they can’t urinate.

Find out more about urinary incontinence.

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Bowel problems

Surgery to the pelvis can irritate the intestines and cause problems, including the following.

The intestines can stop working normally so the contents can’t move through them. This is called paralytic ileus. After surgery, the intestines will slowly start working normally and you will gradually start eating and drinking again.

Bowel obstruction is when the large or small intestine is partially or completely blocked so the contents can’t pass through them. Find out more about bowel obstruction.

The rectum can narrow after surgery (called stricture). This problem is treated by widening, or dilating, the stricture or removing the part of the bowel with the stricture, if the problem is severe.

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Infection

You can develop a wound infection after any type of surgery, but it is not a common side effect. Infection of the urinary tract can occur as a late side effect of surgery to treat bladder cancer. Repeated infections can develop if the urinary tract is blocked (obstructed) or urine backs up into the ureters (called reflux). These repeated infections can lead to chronic kidney infection (called pyelonephritis).

Sometimes the healthcare team places tubes into the wound to drain extra fluid. Antibiotics are used to help prevent or treat infections.

Find out more about infection.

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Stones

Stones (called calculi) are mineral deposits. After surgery, stones can sometimes develop in the kidneys or the urinary pouch created after a radical cystectomy.

It is important to drink lots of fluids. Some people may need to have surgery to remove stones that do not pass out of the body on their own.

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Narrowing of the stoma

If the bladder is removed, the surgeon needs to create a new pouch to hold urine and a new way for urine to leave the body. This type of reconstructive surgery is called a urinary diversion.

Some types of urinary diversion create a stoma, or opening, in the abdomen to allow urine to leave the body. Sometimes this stoma can narrow (called stomal stenosis). Narrowing of the stoma is a late side effect that may develop after ileal conduit reconstructive surgery. It is fairly common after an Indiana pouch or similar surgery. A surgeon can treat narrowing of the stoma by widening, or dilating, it.

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Peristomal hernia

A peristomal hernia is a bulging around the stoma. It can develop as a late side effect of a urinary diversion with an ileal conduit or Indiana pouch reconstructive surgery. Some people may need surgery to repair a hernia.

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Metabolic disorders

Metabolic disorders, such as an electrolyte imbalance, can develop after reconstruction with a urinary diversion. After surgery, your healthcare team will monitor levels of electrolytes, such as potassium and sodium, in the blood. It is important to check your vitamin B12 levels starting about 3 years after surgery.

You may be given supplements to bring electrolyte levels back to normal. Vitamin B12 supplements can be taken without monitoring levels.

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Fertility and sexual problems

Sometimes reproductive organs are removed during a radical cystectomy for bladder cancer. These changes usually lead to erectile dysfunction, or impotence, in men. It also causes a loss of fertility in women. These can be long-term problems.

Find out more about fertility problems and sexual problems for men, including erectile dysfunction.

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anesthetic

A drug that causes anesthesia (the loss of some or all feeling or awareness).

General anesthetics put a person to sleep. Regional anesthetics cause a loss of feeling in a part of the body, such as an arm or leg, but the person does not lose awareness. Local anesthetics numb only a small area of the body.

electrolyte

A substance in the blood and other body fluids that carries an electric charge. Electrolytes are responsible for the movement of nutrients and wastes into and out of cells to keep body fluids balanced and to allow muscles to function properly.

Examples of electrolytes include calcium, chloride, potassium and sodium.

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