Which type of urinary diversion is best for you?

Your bladder acts as a storage house for the urine. It gives you the ability to voluntarily dispose of this waste from your body. When this bladder loses its capacity to store urine, it is called to be not functional. At this point of bladder degradation, you will necessarily need any kind of urinary diversion procedures. A urinary diversion is an operative process through which the disturbed flow of urine is redirected out of the body as it should be essentially expelled.

Bladder non-functionality can be caused due to various reasons such as:

• Surgical removal of the bladder due to the presence of a tumor
• Prostate cancer or enlargement
• Bladder stones
• Dysfunctional urethra
• Urinary tract tear
• Some kind of disruption in any part of the urinary tract

What parts of the urinary tract can affect the functionality of the bladder?

Anything that deals with the flow of urine directly affects the bladder and its function. As the function of the whole urinary tract is to create a flow of urine directed toward the body outlet, every part of the urinary tract is involved in the regulation of bladder function. The human urinary tract consists of the following organs working in complete coordination in order to remove urine out of the body:

Kidneys: These are the primary organs of the urinary tract that perform the most important task of urine production and directing it into the ureters. Kidneys are the essential organs or the human body without which no one can survive as they remove waste and excess water from the blood and produce urine out of this filtrate.

Ureters: From the center of each kidney, a ureter continues which a thin tunnel is made up of muscles. The two ureters transport the urine produced inside the kidneys to the bladder.

Bladder: The two ureters open up inside a triangular bag-shaped organ known as the bladder. The bladder is important for storing urine until it is filled with enough urine to be passed into the urethra for expelling it out of the body. If this important organ is not functioning properly, the flow of urine gets disturbed which can lead to serious hazardous issues. To avoid this, a urinary diversion is done on the patient by the surgeon to relieve the urine from the urinary tract directly to the exterior of the body or into an artificial bladder until further passed.

What are the different ways to divert urine?

Urinary diversions are required when the urinary tract does not function properly and are done by either removing or creating portions of the tract. Depending upon the method used to diver the urine, there are various types of urinary diversion.

Cutaneous Ureterostomy

In this procedure, the ureters are directly connected to the skin and are required in patients who have concurrent bowel disease and patients with very poor health status. In this type of diversion, the GI tract is not involved and the postoperative recovery is quicker. Stenting or revision is required in this procedure due to the presence of a high rate of ureteric stricture.

Ureterosigmoidostomy

It is not a very common urinary diversion procedure as it involves connecting the ureters directly to the sigmoid colon. Patients who go through this type of surgery usually experience severe electrolyte abnormalities and pyelonephritis

Ileal Conduit

This procedure is considered one of the most common types of urinary diversion in which a segment of the bowel is connected to the ureters which in turn are connected to the abdomen to form a stoma from which the urine is passed into an external bag. This procedure is most commonly done in patients who are not able to self-catheterize.

Ileal pouch

It is a type of continent cutaneous urinary diversion in which the bowel is used to create a reservoir to be able to store urine until the patient is ready to intermittently catheterize. One of the advantages of this procedure is that there is minimal leakage of urine as the stoma can be covered with a bandage to help keep the patient dry. This procedure is only done in patients who are able to self-catheterize every 4 hours

Mitrofanoff

This procedure is only differentiated from ilial by the fact that in this procedure the patient still has their native bladder which allows for easier intermittent catheterization.

Orthotopic Neobladder

In this procedure, the intestine is made into a reservoir and is then connected to the native urethra. It is considered one of the most complicated urinary diversion procedures and required a lot of patient examination. 80% of patients who undergo this surgery regain their urinary continence.

Bladder Augmentation

This surgery involves the portion of the bowel to be added to the bladder to increase the storage capacity of the bladder. Patients with overactive bladder are recommended for this procedure. One of the complications of this urinary diversion is that the patient will have increased residual volume.

Urethroplasty

It involves the surgical alteration of the urethra in order to relieve the obstruction. There are many reasons by which a person can develop urinary obstruction and for different causes of this problem, urethroplasty may vary.

Conclusion

There are many indications for which a person may have to consider any kind of urinary diversion procedure. The problem in any part of your urinary tract can cause serious disruption in the flow of your urine. As there are many types of urinary diversions depending upon the area of the tract affected and the nature of the problem, it is necessary for you to get in touch with a specialist like Dr. Dushyant Pawar to determine the best possible type of diversion for your urological complication.

Contact us now to get the best diagnosis for choosing the most suitable urinary diversion for you and to have the most skillful urologist by your side.