Reconstructive surgery is an option for patients who have had their bladder removed, since they will need a way to store and empty their urine. One such procedure is a urostomy. This procedure makes it possible for urine to leave the body from the ureters.
The ileal or conduit procedure involves removing a piece of either the small intestine or the large intestine and forming it into a passageway for urine to get from the kidneys to the outside of the body. A small sac or pouch is created, which stores the urine. This pouch is connected by an opening, called a stoma, to the skin of the abdomen. The urine may be emptied continuously into a small bag placed over the connection and worn under clothing.
Continent diversion is another type of urostomy, but with the pouch having a valve that allows urine to be stored in the pouch and emptied through a catheter placed into the hole several times each day. Because there is no bag on the outside, this procedure is preferred by some patients.
New methods make it possible to actually route the urine into the urethra. This restores a semblance of normal urination. In one procedure, a neobladder is created with a piece of intestine that is sewn to the urethra. This serves as a reservoir for urine and allows the patient to urinate normally.
Aside from a urostomy, a diversion can be made. This can be done without removing the bladder. This procedure is performed so that any blockage of urine flow may be relieved. It is used for patients whose cancer has spread or who cannot be treated with surgery.
Patients with a urostomy or a diversion, may experience side effects such as infection from wounds, urinary incontinence, pouch stones, and an impeded urine flow.
A urostomy can lead to stress in sexual situations. This, however, can be resolved by proper planning. The pouch or the bag may be emptied before sexual activity. This reduces the risk of a major leak during sex. A pouch cover can also be worn during intercourse. The rubbing of the pouch can be avoided by using positions that do not put any weight on the appliance.
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