Is it a superficial recurrence or invasive? In cases where the bladder sparing fails, the tumor is sometimes non invasive. In these cases the patient can have the option of intravesical chemo/BCG.
It it is invasive then cystectomy is the way to go. I applaud your physicians for giving him at least a chance of bladder sparing.
ileal conduits are generally well tolerated and the care is better. The important thing is to get rid of the cancer. He should be able to live a pretty normal life after recovery.