For a few days after TUR, patients may have some blood in their urine and difficulty or pain when urinating. Otherwise, TUR generally causes few problems.

After cystectomy, most patients are uncomfortable during the first few days. However, medicine can control the pain. Patients should feel free to discuss pain relief with the doctor or nurse. Also, it is common to feel tired or weak for a while. The length of time it takes to recover from an operation varies for each person.

After segmental cystectomy, patients may not be able to hold as much urine in their bladder as they used to, and they may need to urinate more often. In most cases, this problem is temporary, but some patients may have long-lasting changes in how much urine they can hold.

If the surgeon removes the bladder, the patient needs a new way to store and pass urine. In one common method, the surgeon uses a piece of the person's small intestine to form a new tube through which urine can pass. The surgeon attaches one end of the tube to the ureters and connects the other end to a new opening in the wall of the abdomen. This opening is called a stoma. A flat bag fits over the stoma to collect urine, and a special adhesive holds it in place. The operation to create the stoma is called a urostomy or an ostomy. The section called "Rehabilitation after Bladder Cancer ¹" has more information about how patients learn to care for the stoma.

For some patients, the doctor is able to use a part of the small intestine to make a storage pouch (called a continent reservoir) inside the body. Urine collects in the pouch instead of going into a bag. The surgeon connects the pouch to the urethra or to a stoma. If the surgeon connects the pouch to a stoma, the patient uses a catheter to drain the urine.

Bladder cancer surgery may affect a person's sexual function. Because the surgeon removes the uterus and ovaries in a radical cystectomy, women are not able to get pregnant. Also, menopause occurs at once. Hot flashes and other symptoms of menopause caused by surgery may be more severe than those caused by natural menopause. Many women take hormone replacement therapy (HRT) to relieve these problems. If the surgeon removes part of the vagina during a radical cystectomy, sexual intercourse may be difficult.

In the past, nearly all men were impotent after radical cystectomy, but improvements in surgery have made it possible for some men to avoid this problem. Men who have had their prostate gland and seminal vesicles removed no longer produce semen, so they have dry orgasms. Men who wish to father children may consider sperm banking before surgery or sperm retrieval later on.

It is natural for a patient to worry about the effects of bladder cancer surgery on sexuality. Patients may want to talk with the doctor about possible side effects and how long these side effects are likely to last. Whatever the outlook, it may be helpful for patients and their partners to talk about their feelings and help one another find ways to share intimacy during and after treatment.

Glossary Terms

A pouch formed from a piece of small intestine to hold urine after the bladder has been removed.

Sexual climax without the release of semen from the penis.

In medicine, describes the inability to have an erection of the penis adequate for sexual intercourse.

The time of life when a woman’s ovaries stop producing hormones and menstrual periods stop. Natural menopause usually occurs around age 50. A woman is said to be in menopause when she hasn’t had a period for 12 months in a row. Symptoms of menopause include hot flashes, mood swings, night sweats, vaginal dryness, trouble concentrating, and infertility.

An operation to create an opening (a stoma) from an area inside the body to the outside. Colostomy and urostomy are types of ostomies.

The fluid that is released through the penis during orgasm. Semen is made up of sperm from the testicles and fluid from the prostate and other sex glands.

The part of the digestive tract that is located between the stomach and the large intestine.

Freezing sperm for use in the future. This procedure can allow men to father children after loss of fertility.

Removal of sperm from a man's testis or epididymis by a doctor using a fine needle or other instrument.

A surgically created opening from an area inside the body to the outside.

An operation to create an opening from inside the body to the outside, making a new way to pass urine.