Once the bladder is separated from the ureters and urethra in an operation cystectomy need to create another method of collecting urine and excretion from the body. There are several options. The choice will depend on your overall health, the degree of development of the disease and the patient's preferences.
Perhaps the use of bowel to reconstruct the organ. Orthotopic term meaning "in the same place." The new bladder is formed from a segment of the small intestine - the ileum. Once a piece of the intestine is removed, the body re-connect. Remote segments are sewn together to form a pouch. The lower part of the bag is connected to the urethra. Thanks to this new bladder will act similarly to a normal body. Ureters the other side is connected to the bladder. The reconstructed body is constructed in such a way as to keep the urine and to control its flow. To speed up the healing of ureteral stent used, a suprapubic catheter and urinary catheter.
However, in the first weeks or months may leak urine. The new bubble can not operate as a normal organ. Control is installed on the process of urination in a few months.
Kontinentnoe urinary diversion
When the disease struck the urethra, it resected. Subsequently apply recovery option after the removal of the bladder - kontinentnoe urinary diversion. To create the bladder using a small section of small intestine and colon. The colon segment create a pouch which functions as a bladder and retains urine. Where the small intestine joins the colon, creating a valve. He ceases to drain urine from the bladder. The end of the small intestine is output to the abdominal wall, creating an opening - stoma. A small catheter is inserted through the stoma inside the body and emptied it 4-6 times a day.
Such recovery of the bladder after surgery requires the patient's ability to self-catheterize the bladder.
When creating orthotopic bladder and urinary diversion kontinentnom will need to wash the body to remove excess mucus. Bubble created from the intestine, so the presence of mucus in the urine - a normal phenomenon after cystectomy.
Possible a simpler version of the reconstruction. To create a reservoir use a short section of the small intestine - the ileum. The ureters are stitched to the pipeline. Formed on abdominal stoma. The tank - a kind of funnel through which urine drains from the kidney into the urine collecting device fastened to the patient's skin. A disadvantage of such reconstruction - wearing the urine collecting device (small plastic bag), the advantage - the operation more simple and short, typical less postoperative long-term complications or for it.
What drains are needed?
To moved urine from the kidney to the bladder and urethra are placed two temporary stent (plastic tube) to be visible from outside the body. When creating a new bladder and urinary diversion kontinentnom also set 1 or 2 for the drainage catheter body as long as it heals.
When the bladder is created from the intestine, the presence of mucus in the urine - a normal phenomenon. Its amount is reduced over time. To prevent clogging of the catheter, it is important to regularly wash the body with sterile water (orthotopic bladder kontinentnoe abduction). Nurses will teach how to do it using catheters.
Stents and catheters used for 2-4 weeks until healing takes reconstructed organ. The surgeon will notify when they need to be removed.