Post-Operative Instructions for Ileal Conduit Cystectomy Patients:

Dr. Scherr has successfully created a new bladder using a piece of your bowel. You have two stents (one pink and one blue), a stoma (a piece of your bowel through your abdomen and skin), a stomach catheter (yellow catheter sutured into the stoma), and a urostomy bag covering your stoma, stomal catheter, and stents.

The stoma will eventually be free of stents and tubes and drain urine on its own. While healing from your robotic cystectomy, these tubes are necessary. The stents allow the ureters to heal to the new bladder and continue to drain urine.

Note: Flushing is not required for an ileal conduit; please do not attempt to flush any of the tubes, stents, or stoma.

Note: You will always have a bag over the conduit.

Urostomy Bag Changing: The Urostomy bag and wafer will need to be changed every 4-5 days and as needed (leaking, damage to bag). If need to order more bags, you can contact our New York City office, or visit Hollister Woundcare's website.

Supplies needed:

• Normal saline solution/sterile water
• Paper towels
• Urostomy bag and wafer with flexible foley catheter connector
• Scissors (dedicated to ostomy care)
• Adhesive skin prep
• Guaze
• Garbage can

Steps for Changing the Urostomy Bag:

1. Wash hands.
2. Put on gloves if desired.
3. Assure that the bag and foley tubing are completely empty prior to making any moves.
4. Place a few paper towels on lap under the bag.
5. Loosen the bag and wafer from the skin, gently assuring that the stents are not catching.
6. Once the bag is removed, gently clean the stoma and skin with a moist gauze pad and pat the skin dry (not the stoma).
7. Place the stent tips in a gauze pad or paper towel to assure that urine does not get on the skin. Note: It is very important that urine does not get on the skin. If it does, be sure to pat the area dry.
8. Measure the stoma and cut the wafer slightly larger, to assure that we do not cause breakdown of the stoma.
9. Prep the skin around the stoma with the skin prep.
10. Separate the front and back of the urostomy bag so that the stents will fit in the bag.
11. Attach the wafer to the urostomy bag and quickly place it over the stoma and stents, sealing it to the skin with gentle pressure from the hands.
12. Reinforce the wafer with ½ paper tape if desired.
13. If the bag continues to leak, that means that the skin was not dry or prepped properly and the process must be repeated with a new wafer.

Post-Hospital:

The stents are removed in Dr. Scherr’s office in approximately one to two weeks, however this will vary from patient to patient. Alert Dr. Scherr if: your temperature becomes greater than 101 degrees F, if you have chills, if nausea and vomiting are persistent, if little urine flows out of stents, if there is little or no pain control, or skin breakdown. Also, if the surgical site becomes red, swells, or if there is drainage, contact Dr. Scherr immediately.

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