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Urinary diversion

Following removal of the bladder there are 3 types of urinary diversion.

A urinary diversion is accomplished by utilizing a piece of intestine and connecting the ureters from the kidneys.
The three main types of urinary diversion include: ileal conduit, neobladder, and continent cutaneous diversion.
The ileal conduit urinary diversion has the fewest surgical complications, as it is the simplest type.
A small opening is created in the skin on the right lower abdomen from which urine drains into a bag.
The bag is worn underneath clothing and is not usually visualized. The bag can be drained every few hours and is changed every few days.
 
Ileal conduit diversion complications include narrowing of the stoma or herniation in the wall around the stoma.
 
A neobladder refers to a small intestine reservoir constructed in the same area as the original bladder and connected to the patient’s urethra. 
 
In such a diversion, patients are able to empty their bladder through the urethra. 
 
This requires training to be able to hold urine without leakage.
 
In a neo bladder surgery,  the procedure takes longer than an ileal conduit and has more associated complications.
In a continent cutaneous diversion, the large intestine is utilized to build a reservoir that stores urine, and is accessed through a channel as a stoma in the skin.
The patient is required to insert a catheter into this urinary diversion pouch through the stoma to drain urine.
This type of diversion is utilized less often than the ileal conduit or neobladder.
Following bladder cancer surgery the ileal can do it urinary diversion is most often used.
Neobladder diversions are usually performed in healthier and younger patients.

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