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An Indiana pouch is a surgically-created urinary diversion used to create a way for the body to store and eliminate urine for patients who have had their urinary bladders removed as a result of bladder cancer, pelvic exenteration, bladder exstrophy or who are not continent due to a congenital, neurogenic bladder.
These include creating a neobladder, which is constructed from intestinal tissue and allows the patient to void urine through the urethra. When the urethra is not functional, a continent cutaneous reservoir, such as an Indiana pouch, can be formed, enabling the patient to drain urine via a catheter through a small abdominal opening.
Urostomy is most commonly performed after cystectomy, such as may be necessary in, for example, bladder cancer.Other indications include severe kidney disease, accidental damage or injury to the urinary tract, surgical complications because of non-related pelvic or abdominal surgery, congenital defects that cause urine to back up into the kidneys, or urinary incontinence.
The ileum and ascending colon can also be used to create a pouch accessible for catheterization (Indiana pouch). Urethral stents or urethral sphincterotomy are other surgical approaches that can reduce bladder pressures but require use of an external urinary collection device. [11] Urethral slings may be used in both adults and children [12 ...
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Kock pouch ileostomy is indicated for patients who are unfit for ileal pouch anal anastomosis (IPAA) because the anus and anal sphincter will be removed during the operation; and patients who develop severe incontinence after IPAA. [1] A Kock pouch need not be created during the initial colectomy surgery. [citation needed]
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