Enhanced Recovery Program

What is Enhanced Recovery After Surgery?

Radical cystectomy is a complicated procedure that impacts you physically and mentally.  To minimize the stress of this major surgery, Roswell Park’s Enhanced Recovery After Surgery (ERAS) program takes a holistic, or whole person approach, to every bladder cancer patient’s care.

Studies show that ERAS programs improve the patient’s quality of care, reduce complications, shorten the hospital stay and speed return to normal activities. Our ERAS program begins on Day One, (day of diagnosis or day you decide on surgery) and focuses on improving your physical and mental health and preventing complications with a number of specific measures that include:

Before Surgery

  • Patient education and counseling to prepare you for what to expect before and after your surgery.
  • Nutrition counseling and health assessment to provide a plan specifically for you that addresses any health issues, helps you to quit smoking and maximizes your nutrition — all of which contribute to a successful surgery.
  • Prehabilitation. Our patients begin working with a physical therapist in the weeks prior to surgery. Our program is designed specifically for cystectomy patients to improve mobility, increase respiratory function and build strength. We provide our patients with a pedometer and log to track their steps and prescribed exercises.
  • Night-before-Surgery Diet that allows you to eat solid food up to six hours before surgery and fluids rich in complex carbohydrates up to two hours before surgery.
  • Blood clot prevention with the use of compression stockings and anticoagulant medications.

After Surgery

  • Promote early return to feeding by removing the nasogastric tube (that delivers liquid nutrition) as soon as possible, allowing you to eat normal foods as you can tolerate them.
  • Provide chewing gum to aid bowel function return.
  • Minimize use of pain medication as tolerated and using other drugs to prevent nausea and vomiting.
  • Remove urinary catheter possibly as early as first follow-up visit.
  • Initiate walking as early as your first day. The sooner you become mobile, the better your recovery. Our physical therapist will come to your room to help you mobilize and resume physical therapy exercises, even while still in bed. Our prehabilitation program greatly improves early mobilization.
  • Follow discharge criteria. Our team works together to help you meet these important steps:
    • Adequate pain control
    • Regular diet
    • Normal bowel function
    • Ability to care for your stoma