What is bladder augmentation?

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Bladder augmentation: Overview

Bladder augmentation is surgery to make the bladder larger and improve the way it can stretch. After surgery, your bladder should be able to hold more urine. You will probably urinate less often. If you use a catheter to drain your bladder, you may be able to use the catheter less often.

The doctor will make a cut in your lower belly. This cut is called an incision. Then the doctor will make an incision to open the top of your bladder. He or she will take a piece of tissue from your intestines or stomach. The doctor will form the piece of tissue into a patch. The patch will cover the open area at the top of your bladder. The doctor will stitch the patch in place. Then the incision in your belly will be closed with stitches or surgical staples. You will have a scar on your belly that will fade with time.

Most people go home 4 to 7 days after surgery. You will probably be able to go back to work and most of your usual activities in 4 to 6 weeks. But you may need up to 3 months to fully recover.

How can you care for yourself after bladder augmentation?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 6 to 8 weeks or until your doctor says it is okay.
  • For 6 to 8 weeks or until your doctor says it is okay, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
  • Ask your doctor when you can drive again.
  • You will probably need to take 4 to 6 weeks off from work. It depends on the type of work you do and how you feel.
  • You may shower as usual. Pat the cut (incision) dry. Do not take a bath until your doctor tells you it is okay.
  • Ask your doctor when it is okay for you to have sex.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • Drink plenty of fluids (unless your doctor tells you not to).
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
  • Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.

Other instructions

  • If your doctor has told you to flush your bladder, follow his or her instructions on how to do this.

How do you prepare for bladder augmentation surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • You may need to go to the hospital the day before surgery to get laxatives to empty your bowels.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

After bladder augmentation: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have severe trouble breathing.
  • You have sudden chest pain and shortness of breath, or you cough up blood.
  • You have severe pain in your belly.

Call your doctor now or seek immediate medical care if:

  • You have bright red vaginal bleeding that soaks one or more pads in an hour, or you have large clots.
  • You are sick to your stomach or cannot keep fluids down.
  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incision comes open.
  • Your incision is bleeding.
  • You have vaginal discharge that has increased in amount or smells bad.
  • Your catheters come out.
  • Your catheters are not draining urine, even after you flush your bladder.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You have clots of blood in your urine.
  • You have trouble passing urine or stool, especially if you have pain or swelling in your lower belly.
  • You have new or worse pain when you urinate.
  • You have pain in your back just below your rib cage. This is called flank pain.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not have a bowel movement after taking a laxative.

After bladder augmentation surgery: Overview

Bladder augmentation is surgery to make the bladder larger and improve its ability to stretch. After surgery, your bladder should be able to hold more urine. After surgery, you may feel weak and tired at first. You will probably feel some pain or cramping in your lower belly and may need pain medicine for a week or two.

You will have a tube coming out of the cut the doctor made (incision) in your skin just above the pubic bone. This is called a suprapubic catheter. You also may have a catheter in your urethra, which is the tube that carries urine from the bladder to outside your body. These catheters will drain urine and mucus from your bladder for the first few weeks after surgery. Your doctor will do a test to check the strength of your bladder about 2 or 3 weeks after surgery. When your doctor has made sure that there are no leaks in your bladder, the catheters will be taken out.

You will probably be able to go back to work and most of your usual activities in 4 to 6 weeks. But you may need up to 3 months to fully recover. Try to avoid heavy lifting and strenuous activities that might put extra pressure on your bladder while you recover.

After this surgery, most people use a catheter to empty their bladders. Your care team will teach you how to use a straight catheter. They will also help you with any bladder care needs you have.

What happens on the day of bladder augmentation surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 3 hours.

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