M.Ch - Urology/Genito-Urinary Surgery, MS - General Surgery, MBBS
Urologist, Mumbai
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46 years experience
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There are three different types of urinary diversion
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Before urine is expelled from the body, it is stored in the bladder. In cases where the bladder is no longer able to function as a reservoir for urine, a urinary diversion may be created through a surgical procedure. This redirects the flow of urine out of the body. There are three types of urinary diversions. These are the ileal conduit urinary diversion, the neobladder to urethra diversion and the orthotopic continent urinary diversion. Bladder cancer is one of the most common causes of urinary diversion.
The most common procedure followed to create a urinary diversion is
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The ileal conduit urinary diversion is the most common procedure used to create a urinary diversion. This is also known as a urostomy. For this procedure, a small portion of the patient s bowel is used to create a passage for the urine to flow from the ureters to an opening in the abdomen. This opening is called a stoma. A bag is then used to collect urine from the stoma. This bag needs to be emptied frequently and can be worn under the patient s clothes.
A bag is not required for Orthotopic continent urinary diversion.
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In the case of an orthotopic continent urinary diversion, an external bag is not required to collect the urine. Instead, a part of the bowel is used to create a small pouch inside the patient s abdomen. This is connected to the ureters and is used to collect urine. As in the case of an ileal conduit urinary diversion, a stoma is created in the patient s abdomen. This is connected to the pouch with a valve. A catheter can then be used to drain the pouch through the stoma. In most cases, a catheter is used to drain the pouch 4-5 times a day.
In the case of a Neobladder to urethra diversion urine is passed out of the body through
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This procedure also involves creating a pouch using part of the bowel to store urine. The top of this pouch is connected to the ureters and the bottom is connected to the urethra. Thus, it allows urine to flow out of the body through the urethra. This offers a urinary experience that is quite close to normal. Neobladder to urethra diversion is not an option for all patients.
A urinary diversion may be needed after cancer treatment
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Treatment for cancer such as chemotherapy and radiation can affect the bladder. In the case of certain types of cancer such as cancer of the ovary, uterus, colon, cervix or vagina, doctors may advise removal of the bladder if the cancer is at an advanced stage. This is because there may be a high risk of cancer spreading to the bladder. In such cases, urinary diversion is usually recommended. In the case of advanced cancer, urinary diversion may be prescribed as a form of palliative care.