Saturday, April 14, 2012

Urinary diversion after radical cystectomy

Urinary diversion after radical cystectomy
From an anatomical standpoint three alternatives are presently used after cystectomy:
Abdominal diversion such as uretherocutaneostomy, ileal or colonic conduit, and various forms of a continent pouch.
Urethral diversion which includes various forms of gastrointestinal pouches attached to the urethra as a continent, orthotopic urinary diversion (neobladder, orthotopic bladder substitution).
Rectosigmoid diversions, such as uretero (ileo-) rectostomy.

Different types of segments of the intestinal tract have been used to reconstruct the urinary tract, including the stomach, ileum, colon, and the appendix.

Several studies have compared certain aspects of health-related quality of life, such as sexual function, urinary continence and body image, in patient cohorts with different types of urinary diversion. However, further research is needed on pre-operative tumour stage and functional situation, socio-economic status, time interval to primary surgery, etc.



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