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The other type of urostomy is cutaneous ureterostomy. With this technique, the surgeon detaches the ureters from the bladder and brings one or both to the surface of the abdomen. The hole created in the abdomen is called a stoma, a reddish, moist abdominal protrusion. The ileal conduit is not painful; it has no sensation.
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.
Incontinent stoma as part of a Bricker ileal conduit. To create an ileal conduit, the ureters are surgically resected from the bladder and a ureteroenteric anastomosis is made in order to drain the urine into a detached section of ileum at the distal small intestine, though the distal most 25 cm of terminal ileum are avoided as this is where ...
Diagram showing how a urostomy is made (ileal conduit). Date: 30 July 2014 (released by CRUK) Source: Original email from CRUK: Author: Cancer Research UK: Permission (Reusing this file) This image has been released as part of an open knowledge project by Cancer Research UK. If re-used, attribute to Cancer Research UK / Wikimedia Commons
The other end of the channel is sewn to the bladder and a flap valve of tissue is created to prevent leakage from the stoma between catheterizations. [3] Sometimes, the bladder is enlarged with bowel tissue to enable greater urine storage in an additional procedure called bladder augmentation. [3]
Some patients, after having had an ileal conduit, requiring an external appliance, have opted to have the Indiana pouch, as elective surgery. Such a surgery is usually recommended, if possible, since it has been documented that the Indiana pouch may reduce the possibility of kidney damage because the ureters are repositioned lower in the abdomen.
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This operation is no longer popular in many countries, with an ileal conduit (where the ureters lead into a loop of small intestine) being preferred. However, ureterosigmoidostomy is still popular in developing countries, as the maintenance of an ileal conduit or catheter is seen to be more difficult. [citation needed]