Urinary diversion

Urinary diversion is a surgical procedure that reroutes the normal flow of urine from the kidneys and ureters into a surgically created pathway. This procedure is often performed when the bladder is not functioning properly or has to be removed due to disease. There are several types of urinary diversion, including ileal conduit, continent urinary reservoir, and orthotopic neobladder.

Indications

Urinary diversion is typically indicated in cases where the bladder is not functioning properly or has to be removed. This can be due to a variety of conditions, including bladder cancer, neurogenic bladder, interstitial cystitis, and trauma to the bladder.

Types

There are several types of urinary diversion, each with its own advantages and disadvantages.

Ileal Conduit

In an ileal conduit procedure, a small piece of the ileum is used to create a conduit for urine to pass from the kidneys to the outside of the body. The end of the conduit is brought to the surface of the skin to create a stoma, through which urine is expelled.

Continent Urinary Reservoir

A continent urinary reservoir is a pouch created from a piece of the intestine. The pouch is connected to the ureters and a stoma is created on the skin's surface. Unlike an ileal conduit, a continent urinary reservoir requires the patient to use a catheter to empty the pouch.

Orthotopic Neobladder

An orthotopic neobladder is a pouch created from a piece of the intestine that is connected to the ureters and the urethra. This allows the patient to urinate in a manner similar to natural urination.

Complications

Complications of urinary diversion can include infection, urinary stones, urinary incontinence, and renal failure. Long-term follow-up and management are necessary to monitor for these potential complications.

See Also

• Urostomy
• Cystectomy
• Bladder cancer

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