Our Summary

This research paper examines the long-term complications associated with a procedure called urinary diversion, which is a common surgical treatment for patients with aggressive bladder cancer. This surgery has significantly increased survival rates, but can lead to complications down the line. The paper reports that up to 60% of patients experience complications, which can include kidney issues, problems with urination, complications related to the surgical opening (stoma) created during the procedure, bowel issues, narrowing of the connection between the ureter and intestine, metabolic disorders, and infections. The most common complications are ones related to the stoma and urinary tract infections. Given that these issues can arise years after the surgery, the paper stresses the importance of regular, long-term follow-up care for patients who have undergone urinary diversion.

FAQs

  1. What is urinary diversion surgery and why is it performed?
  2. What are the common long-term complications associated with urinary diversion surgery?
  3. Why is regular, long-term follow-up care important for patients who have undergone urinary diversion surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about urinary diversion surgery is to maintain regular follow-up appointments with their healthcare provider to monitor for any potential complications or issues that may arise in the future. It is important to stay proactive and address any concerns or symptoms promptly to ensure the best possible outcomes and quality of life after surgery. Additionally, patients should be educated on proper stoma care and hygiene to prevent infections and other complications. It is also important to stay informed about any lifestyle modifications or changes that may be necessary post-surgery to optimize overall health and well-being.

Suitable For

Patients who are typically recommended urinary diversion surgery include those with aggressive bladder cancer that has not responded to other treatments, such as chemotherapy or radiation therapy. Other patients who may require urinary diversion surgery include those with advanced or recurrent bladder cancer, those with neurogenic bladder dysfunction due to conditions such as spinal cord injury or multiple sclerosis, and those with congenital abnormalities of the urinary tract that have not responded to other treatments.

Additionally, patients with benign conditions such as interstitial cystitis, chronic urinary retention, or severe urinary incontinence may also be recommended for urinary diversion surgery. These patients may have failed other conservative treatments and may benefit from a surgical intervention to improve their quality of life.

Overall, patients who are recommended urinary diversion surgery are those who have failed other treatment options for their underlying condition and who are deemed appropriate candidates for this surgical procedure by their healthcare provider.

Timeline

Before urinary diversion surgery:

  1. Patient is diagnosed with aggressive bladder cancer and undergoes various tests and evaluations to determine the best course of treatment.
  2. Patient and medical team decide that urinary diversion surgery is the best option to remove the cancerous bladder and create a new way for urine to leave the body.
  3. Patient undergoes pre-operative preparations, which may include imaging tests, blood work, and consultations with various specialists.
  4. Surgery is scheduled and patient undergoes the procedure, which can involve removing the bladder, creating a stoma, and connecting the ureters to a new exit point for urine.

After urinary diversion surgery:

  1. Patient experiences pain and discomfort post-operatively and is closely monitored for any complications.
  2. Patient undergoes rehabilitation and learns how to care for the stoma and manage urinary output.
  3. Patient may experience complications such as infections, urinary tract issues, bowel problems, or metabolic disorders in the months and years following the surgery.
  4. Patient receives regular follow-up care to monitor for long-term complications and address any issues that arise.
  5. Patient adjusts to life with a stoma and may need to make lifestyle changes to accommodate the new way of urination.
  6. Patient continues to have regular check-ups and screenings to monitor for any signs of cancer recurrence or other health issues related to the surgery.

What to Ask Your Doctor

  1. What are the potential long-term complications of urinary diversion surgery that I should be aware of?
  2. How often should I schedule follow-up appointments after the surgery?
  3. What symptoms should I watch out for that may indicate a complication from the surgery?
  4. Are there any lifestyle changes or precautions I should take to minimize the risk of complications?
  5. What can I do to prevent urinary tract infections after the surgery?
  6. Will I need to make any modifications to my diet or medication regimen after the surgery?
  7. How likely is it that I will experience complications, and what can be done to address them if they arise?
  8. Are there any support groups or resources available to help me cope with the potential challenges of living with a urinary diversion?
  9. How will the surgery impact my daily activities and quality of life in the long-term?
  10. Are there any alternative treatments or procedures that may be more suitable for my individual situation?

Reference

Authors: Amini E, Djaladat H. Journal: Curr Opin Urol. 2015 Nov;25(6):570-7. doi: 10.1097/MOU.0000000000000222. PMID: 26372035