Our Summary

This research paper is a review about an operation called the “ileal conduit”. This procedure is often done when a person’s bladder needs to be removed, and a new way for urine to leave the body is needed. The paper has three main focuses:

  1. It explains how the surgery is done, highlighting key principles that surgeons should follow.
  2. It provides information on what should be considered before and after the operation.
  3. It gives an overview of the potential risks and complications that might occur in the long-term, as well as how this procedure might affect a person’s quality of life.

The paper’s goal is to inform a wide range of medical professionals about this procedure.

FAQs

  1. What are the main objectives in performing the ileal conduit surgery?
  2. What are the preoperative and postoperative considerations for the urinary diversion surgery?
  3. What are the potential long-term complications and impacts on quality of life after the urinary diversion surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about urinary diversion surgery is to carefully follow the postoperative care instructions provided by the medical team. This can include proper stoma care, monitoring for signs of infection or complications, and adhering to dietary recommendations to prevent issues such as kidney stones. Regular follow-up appointments with the healthcare provider are also important to monitor the patient’s progress and address any concerns that may arise.

Suitable For

Patients who are typically recommended urinary diversion surgery include those with bladder cancer that has not responded to other treatments, patients with neurogenic bladder dysfunction, patients with chronic bladder infections, patients with congenital abnormalities affecting the bladder, and patients with bladder dysfunction due to other medical conditions.

Timeline

Before Urinary Diversion Surgery:

  1. Patient undergoes extensive preoperative evaluation including imaging studies, blood tests, and consultations with various specialists.
  2. Patient may undergo a period of preoperative preparation such as bowel preparation and cessation of certain medications.
  3. Patient receives detailed information about the surgical procedure, potential risks and complications, and postoperative care.

During Urinary Diversion Surgery:

  1. Surgical team performs cystectomy (removal of the bladder) and creates an ileal conduit using a segment of the small intestine.
  2. Ureters are reimplanted into the conduit to allow for urine drainage.
  3. Stoma is created on the abdomen for urine to pass through.

After Urinary Diversion Surgery:

  1. Patient is monitored closely in the immediate postoperative period for complications such as infection, bleeding, and ileus.
  2. Patient undergoes a period of recovery in the hospital, which may involve pain management, physical therapy, and education on stoma care.
  3. Patient may need to make adjustments to their lifestyle and diet to accommodate the changes in urinary elimination.
  4. Long-term follow-up includes monitoring for complications such as stomal hernia, urinary tract infections, and metabolic issues.
  5. Patient may experience improvements in quality of life due to relief from symptoms of the underlying condition that necessitated the surgery.

What to Ask Your Doctor

  1. Can you explain the surgical steps involved in the ileal conduit procedure and any important surgical principles I should be aware of?
  2. What are the potential risks and complications associated with this surgery, both in the short-term and long-term?
  3. How will my quality of life be impacted after undergoing urinary diversion surgery with an ileal conduit?
  4. What are the preoperative considerations I should keep in mind before undergoing this procedure?
  5. What steps should I take to care for my stoma post-surgery and prevent complications such as stomal hernia?
  6. How often will I need follow-up appointments and monitoring after the surgery?
  7. Are there any lifestyle changes I should make after the surgery to optimize my recovery and long-term health?
  8. What are the alternatives to the ileal conduit procedure, and why is this option recommended for me?
  9. How will my urinary function be affected after the surgery, and how can I manage any potential changes in bladder control?
  10. Are there any support resources or counseling services available to help me adjust to life with a urinary diversion?

Reference

Authors: Lee DJ, Tyson MD, Chang SS. Journal: Urol Clin North Am. 2018 Feb;45(1):25-36. doi: 10.1016/j.ucl.2017.09.006. PMID: 29169448