Complications of cystectomy

Some problems occur soon after surgery, such as infection, bleeding, blood clots, chest infection, or delayed bowel activity. Others develop later, including narrowing where urinary structures join, hernia, stones, leakage, repeated urinary infections, or changes in kidney function.

A urinary diversion changes how urine is stored or leaves the body. Reduced drainage may come from a kink, mucus blockage, narrowing, dehydration, or another mechanical problem. Skin around a stoma can become sore if urine leaks beneath the appliance.

Using bowel tissue to create the diversion can alter salt or vitamin balance in some people. Pelvic surgery may also affect nerves and blood vessels involved in erections, ejaculation, orgasm, vaginal comfort, and fertility. Follow-up checks help identify concerns before they cause lasting harm.

Use prescribed blood-clot prevention, walk as advised, and practise breathing exercises taught by the hospital team. Follow the written plan for drinking fluids, wound care, appliance changes, catheter flushing, or pouch emptying. Do not insert or remove tubes unless you have been trained to do so.

Check the stoma and surrounding skin during appliance changes, and note substantial changes in urine colour, smell, volume, or flow. Keep follow-up appointments for kidney tests, imaging, and diversion review. A stoma nurse can help correct leaks or poor appliance fit.

Call the surgical service urgently if urine stops draining, a catheter falls out, pain is escalating, the abdomen becomes increasingly swollen, vomiting continues, or fever occurs with cloudy or foul-smelling urine. Wound separation, spreading redness, pus, and new one-sided leg swelling also need prompt assessment.

Get emergency help for sudden breathlessness, chest pain, fainting, uncontrolled bleeding, severe confusion, or marked weakness. Do not try to solve complete loss of urine flow by forcing fluid through a tube unless your clinical team specifically trained you for that situation.

Ask which complications are most relevant to your health and diversion type, how to distinguish expected mucus from blockage, and which phone number to use after hours. Discuss kidney monitoring, sexual rehabilitation, stoma supplies, travel preparation, and who can review recurring leaks, infections, or skin irritation.