Urostomy

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Types of urostomies

There are 2 basic options for urostomy surgery: the standard or conventional urostomy and the continent urinary reservoir. There are many factors that must be considered when deciding which type is needed. The surgeon will talk with you about which is best for you.

Standard or conventional urostomy

    Reasons surgery may be needed:

    Bladder cancer

    Neurologic dysfunction

    Birth defects

    Chronic inflammation of bladder

    Output:

    Urine and some mucus; will be continuous (non-stop) drainage

    Management:

    Skin protection is needed; will use a drainable, valve-end pouch that is adaptable to night drainage

For this type of urostomy, an ileal conduit is made. An ileal conduit is a small pouch that holds urine. It is surgically created from a small piece of bowel.

To make an ileal conduit, a 6- to 8- inch piece of the small bowel (also called the ileum) is cut out near where it attaches to the large bowel. The rest of the ileum is then re-connected to the large bowel. The ureters are detached from the bladder and attached to the piece of ileum that was removed. The bladder may or may not be removed. The far end of the piece of ileum is brought through the abdominal wall to form a stoma. The other end is sewed closed to make a pocket that holds the urine inside the body. This surgery is a life-long change. The urine output is not controlled and this person will have to wear a collection pouch at all times.

Diagram of the digestive system

The small intestine produces mucus naturally. The segment of intestine that was used to form the ileal conduit or urine pocket will keep making mucus, too. The mucus will collect in the pouch along with the urine.

Continent urostomies

For a continent urostomy, the surgeon also makes an internal pouch. In this case, the pouch has valves to keep the urine from backing up the ureters into the kidneys. There is also a valve to keep the urine in the pouch until it is removed. The pouch must be drained 4 or 5 times a day with a thin, flexible tube called a catheter. The doctor or ostomy nurse will help you make a schedule to do this.

Different types of continent urostomies:

Diagrams of a Kock Pouch, Indiana Pouch, Mitrofanoff Procedure, and Ileal Neobladder.


Last Medical Review: 03/17/2011
Last Revised: 03/17/2011