Bladder Augmentation worries

[MrsChewitt]

Hi! Sorry if I put this in the wrong place I'm new and this is my first post!

I am due to have a bladder augmentation on Monday foe neurogenic bladder. I understand that it is a big operation etc etc and have followed many options before coming to this decision so I am not asking if I should have it done or not etc but just some advice or opinions on a couple of things playing on my mind.

My surgeon, who has done this op many times in the past, when I saw him the other day told me I did not need to do a full bowel prep, just to have a light diet for 4 days before and to take cloxal and senna tablets and lactulose for 4 days, and on the morning I will have a micro lax enema. Reading everything I can about this op everywhere says you will have a bowel prep (?) not sure if it is important to my question but he plans to use a portion of small bowel.

Also when I asked about the NG tube he said he doesn't put them i'n as a matter of course and to see how I went. I thought that my bowel would "be asleep" after and no NG will mean I will vomit. He also said I can continue my oral Meds post surgery with a mouthful of water. I am worried as I take carbamazipine for seizures and am quite sensitive my levels.

Has anyone else had this op and not had bowel prep and/or NG?

I am not a SCI patient if that makes a difference? I had a severe brain injury in may 2010 and my bladder problems and also my seizures are caused by that.

Thanks in anticipation!

Mrs x

[new dimension]

My son had the surgery January of 2011. The surgery itself was a success. The hospital stay was the most challenging 7 to 10 days although my son has a SCI C5 C6. We had both bowel prep (what you described...enema) and the tube. The tube was very difficult and after it was finally removed the recovery was much easier. We did a lot of suctioning of vomit to prevent additional problems. That being said make sure you have someone around with you all the time until you are comfortable as my son with no hand function would not have been able to mange on his own. Getting the appropriate bed and shower chair was a challenge. Actually ended up bring our own from home as we were concerned with skin issues. And then cathing frequently seemed daunting but really was manageable. I would recommend good help/support while you recover. Good luck...worth it in the end! Peace be with you!

[SCI-Nurse]

I would ask these questions to your surgeon. You are in a little different boat than most of the folks on this site. That could be part of the reason for the differences in care. Explain to him that these are things you heard were standard. What are his reasons for not doing them?

Good luck to you! I agree that a strong support system is Very important!
CKF

[smashms]

i can recommend the UOAA.org website as it has a message forum specifically for those with augmentations. i have not heard about doing one without a bowel prep or NG because as you said it is standard of care. i question your surgeon on his decision not to do it without one. I do wish you luck!!

[faith9778]

Best wishes to you on this, but if I had it to do over again I would have never gotten a bladder augmentation. The only reoccurring health issues I have today relate to that surgery I had over 15 years ago.

About the surgery, I had a three day hospital stay before the surgery to get cleaned out and had a NG tube for several days after the surgery.

[MrsChewitt]

Thanks everyone for your answers! I plan to ask my surgeon about it but seeing as I won't see him till Monday morning before I go to theatre I thought I'd get some ideas here too! I have decided that I am going to request that he puts an NG tube because of my worries about absorbing my Meds. I am not too worried about having one as i had one for a long time post accident and also last year had a camera put inti my nose and down my throat, neither bothered me too much, i have a very much reduced gag on my left side (oh the wonders of brain injury!) which can be a pain a lot of the time but maybe it has a little benifit?!

I have kind of been doing my own semi bowel prep, very light diet for the last few days and been taking lactulose for a week, today and tomorrow I plan on just having clear fluids, hopefully that will all clean me out enough!

I know this is big surgery, it will be my 5th major since the accident, only the 3rd I remember though, (none on my bladder) and I am well prepared. I am fully expecting the "Oh my god what have I done" feeling and wil have my hubby around all the time, we are lucky with a great support of close friends around too )

Faith I am so sorry that things didn't work out for you, (
I am aware that it might not turn out to be the "fix" I am looking for but weighing it up looking at what this "could" give me I am more than willing to take the gamble.

As with my previous surgery I am strangely excited to get this show on the road!

Thanks again

Mrs

[QnMary]

Hi, my augmentation and mitrafanoff was done by one of the top urology surgeons in the country at the Univ of WI hospital. I did not have an NG tube and did fine (I did have a bowel prep). I even had some oral meds with very small amounts of water after 36 hours. I was in the hospital 8 days. If youu intem. cath, you will Definately appreciate the augmentation.

[MrsChewitt]

Hi All!
I thought i would come back and give a quick update for anyone interested!
Well i had my surgery on 29th oct, only minimal bowel prep, ie coloxal and micro enema on the morning.
Surgury took about 4 hours and i woke up in ICU as planned. No NG tube. The worst thing in the first day or so was i was given a pca of fentenal which i hated the effects of so didnt really use it, after 24 hours my surgeon put me on to oral endone which was much better. i ended up staying in ICU for 5 days which wasnt planned and not really to do with surgury i had some strange heart rythums ?to do with my ppic line. To be honest i felt like a bit of a fraud being there as apart from sore tummy i felt fine!
Once i went down to the ward and graduated from clear fluids to light diet etc, surgeon said i could go home once i had bowels open. Hmmmm......that took until day 20 post op! (we had a poo party when it happened!)
So in all i spent 22 days in hospital, 24 hours on pca, then oral pain meds, by 1 week post op was prob taking 5-10mg endone twice a day and panadol in between. my catheter was removed on i think day 18 and yes i peed every hour for a few days, then after 3 days i slept through the night and at 5am did a 350ml pee (pre op was holding max 80ml!)
since discharge i guess it took a month to get to be cathing prob 4-5 times in 24 hours between 350 and 450 mls. i have had NO accidents, my bowel has not been affected at all (touch wood) i have had a slight infection on and off but no big problems.
All in all this is the best thing to happen to me, i guess i was lucky and had an easy time but the whole thing was nothing like as bad as i was expecting.
i guess every one has to make their own decisions but thank you all for the advice on here, but for me i would do it all again in a heartbeat
claire

[SCI-Nurse]

Yes it is a major surgery and what you describe is pretty common.
But all say it is worth it after healed! Glad to hear from you with the good news
CWO

[ceejay6901]

hey im due bladder augmentation in april im 22 and i havent really been talked through it, i know how the operation works im just really worried aboutthe pain afterwards?? iv heard people say its worse than being hit by a truck! and also how much care i will need and with what also could you help me out with like what to expect with bowel movements and do u now hav to catheterise as im not keen on that idea long term x