ileus after radical cystectomy

Hi, My husband had RC Sept 2025. Our oncologist said the best thing you can do is walk, chew gum, and take colace regular strength 2 times each day . We did and he did well. He had to take senokot ( gentle natural laxative) once or twice a week if he did not have a bowel movement in 2-3 days. Not sure about the coffee. He usually went daily and no ileus problems . Hope that helps, Blessings to you.

@skybolt I am considereding RC based on an inflamed bladder with symptoms. The urology team suggests 5 days in hospital few weeks of recovery minimal complications. True?

Dear @sperio, I would say so. I was 63 and healthy except for the cancer. RC was done robotically along with a radical hysterectomy. (6 small incisions versus open surgery) . I have a urostomy pouch. I felt great after the surgery and was ready to go home in 4 days. I was able to walk the next day and in fact overexerted a bit while in the hospital . My doctor said I needed to walk as much as I did but to pace myself throughout the day😊. I had an easy recovery at home. Everything worked well and I was just more tired than usual. The best part was finally being able to sleep without interruption again. Before the RC I had terrible bladder spasms and was waking up every hour for the bathroom.

They recommended this to me also. I did it for a few days and then forgot. No real issues since.

@141emp well, that post op is encouraging. I wonder if the experience is more significant for a male?

Most of the commenters seem to be in the Mayo system and I am not (UTSW, in Dallas). But their "thing" is to keep you in the hospital until your bowels are functioning. So my surgeon's efforts to predict how long I'd be hospitalized always had that caveat. I ended up spending 7 nights in the hospital, waiting for that part of my body to "activate". Just FYI, for what it's worth.

@leantomm Hello and welcome to MAyo Connect. My husband had RC/prostatectomy with neobladder at MAyo in MN 5 years ago. He was told to expect a week in hospital and it was a couple days longer than that waiting for his bowel function to return. He walked daily from day 1 and often twice daily as he improved. The gum and mint suggestion was offered but with Opioids for pain it was very slow. A helpful resident suggested we bring him McDonalds food as that always seems to work! He was only able to down a little bit, but it tasted batter than hospital food and his gut started working in a couple of days. A nurse suggested prunes, of which he ate too many and then had a very painful gas filled belly. I believe the activity is most important, and cutting back on Opioid medication as soon as possible. Robotic surgery would help as there is less incisional pain while recovering.

@141emp did you have the option of the neobladder? If so, what made you decide on the pouch. Husband is currently awaiting treatment for recurrent bladder cancer post BCG. Meeting with oncology for immunotherapy ( Keytruda /EVK IV ). Next step is surgery to remove his bladder. I need all the education and support I can get. He is 72. Healthy otherwise and active.

Dear @ronniek ,
I did have the option but after a few months of not being able to sleep due to increasing urgency/frequency I just couldn’t bear the thought of having to train the neobladder overnight or continued incontinence and the possibility of needing to self catheterize. I also read that it was an easier less complicated procedure. My initial surgeon in NJ wasn’t much help, basically gave me a bunch of reading material to figure it out for myself. I went for a second opinion at a major NYC hospital. The surgeon was quite different and phenomenal. I had already made up my mind about the pouch but he pretty much confirmed my understanding. I’ve had no real issues with the pouch since surgery in 2024 other than some minor skin irritation under the pouch.
The ostomy nurses at the hospital are great and continue to provide support when I have questions. I drink a lot of water so I need to empty the pouch every 1 to 1 1/2 hours and change it every 4 days. I also use an overnight collection bag attached to the pouch so I can sleep a blissful 7 to 8 hours again as long as nothing else is keeping me up. I’m actually more active now than I was the 2 years before cancer and do functional strength training several times a week among other things. Everyone’s experience is different. I only personally know one person with a neobladder from my hospital’s support group. He still experiences some incontinence at night after 2 years but is otherwise doing great. There are folks in this group who chose neobladder with a variety of experiences.
Best wishes !

Thank you for sharing you experience with us. So many difficult decisions to make. Met with oncologist yesterday.
Did you forego hematology and or oncology treatment prior to your surgery. If so, what kind of treatment did you do and how did you tolerate the treatments.
Hoping and praying you continue to do well.