Our Summary

This research paper explores the common problem of urolithiasis, or urinary stone formation, in patients who have undergone cystectomy (bladder removal) and urinary diversion. These patients often have complex anatomy and other health issues, making their cases difficult for urologists to manage. The paper reviews existing literature to identify risk factors for urinary stone formation in these patients and evaluate the success of various treatment options.

FAQs

  1. What is urolithiasis and how is it related to urinary diversion surgery?
  2. What are the identified risk factors for urinary stone formation in patients who have had a cystectomy and urinary diversion?
  3. What treatment options are available for urinary stone formation in patients who have undergone urinary diversion surgery, and how successful are they?

Doctor’s Tip

One helpful tip a doctor might tell a patient about urinary diversion surgery is to stay well-hydrated and maintain a healthy diet to help prevent urinary stone formation. It is important to consume plenty of water and avoid foods high in oxalates, such as spinach, nuts, and chocolate, which can contribute to stone formation. Patients should also follow up regularly with their healthcare provider for monitoring and management of any potential complications.

Suitable For

Patients who have undergone cystectomy and urinary diversion surgery are typically recommended urinary diversion surgery if they experience complications such as:

  1. Recurrent urinary tract infections: Patients who have a history of recurrent UTIs may benefit from urinary diversion surgery to prevent further infections and improve their quality of life.

  2. Incontinence: Patients who experience urinary incontinence following cystectomy may be recommended urinary diversion surgery to help control their bladder function and improve their overall continence.

  3. Urinary obstruction: Patients who develop urinary obstruction after cystectomy may require urinary diversion surgery to alleviate the blockage and restore normal urine flow.

  4. Urinary stone formation: Patients who develop urinary stones in their diverted urinary tract may be recommended urinary diversion surgery to remove the stones and prevent further complications.

  5. Bladder cancer: Patients who have bladder cancer and undergo cystectomy may require urinary diversion surgery as part of their treatment plan to remove the cancerous cells and prevent recurrence.

Overall, patients who undergo cystectomy and urinary diversion surgery may be recommended urinary diversion surgery if they experience complications related to their diverted urinary tract, such as recurrent infections, incontinence, obstruction, urinary stone formation, or cancer.

Timeline

Before urinary diversion surgery:

  • Patient is diagnosed with a condition such as bladder cancer, neurogenic bladder, or chronic bladder infections that necessitates bladder removal
  • Patient undergoes preoperative testing and evaluation to determine the best type of urinary diversion for their case (ileal conduit, continent urinary reservoir, or neobladder)
  • Patient undergoes the surgical procedure to remove the bladder and create the urinary diversion
  • Patient may experience complications such as infection, bleeding, or bowel dysfunction in the immediate postoperative period

After urinary diversion surgery:

  • Patient requires close monitoring in the hospital for complications such as urinary leaks, infection, or bowel obstruction
  • Patient begins learning how to manage their urinary diversion, including changing ostomy bags, catheter care, and monitoring for signs of infection
  • Patient may experience issues such as urinary stone formation, urinary tract infections, or electrolyte imbalances related to their urinary diversion
  • Patient may undergo additional procedures or treatments to manage complications or improve function of the urinary diversion
  • Patient requires long-term follow-up care to monitor for complications, assess kidney function, and address any issues that arise related to the urinary diversion.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with urinary diversion surgery?
  2. How will the surgery impact my daily life, such as diet, activity level, and bathroom habits?
  3. What type of urinary diversion surgery is recommended for my specific case?
  4. How long is the recovery period after urinary diversion surgery?
  5. What are the long-term effects of urinary diversion surgery on my overall health and quality of life?
  6. What follow-up care will be required after the surgery?
  7. How often will I need to be monitored for urinary stone formation after the surgery?
  8. What steps can I take to prevent urinary stone formation after the surgery?
  9. Are there any dietary or lifestyle changes I should make to reduce my risk of complications?
  10. What are the success rates of urinary diversion surgery in patients with similar health conditions or anatomical challenges?

Reference

Authors: Seth JH, Promponas J, Hadjipavlou M, Anjum F, Sriprasad S. Journal: Urolithiasis. 2016 Oct;44(5):383-8. doi: 10.1007/s00240-016-0880-y. Epub 2016 Apr 25. PMID: 27114354