In Reply to: Time to go after some Colorado commits* posted by TJJ on July 28, 2025 at 09:00:17
Had his bladder removed.
Here's the upshot:
If the bladder is removed (cystectomy), a urinary diversion is needed to allow urine to exit the body. This involves creating a new way for urine to be collected and expelled, either through a neobladder, a continent urinary reservoir, or an ileal conduit (urostomy). Each method has its own considerations and potential complications. [1, 2, 3, 4, 5, 6]
Understanding the Options:
• Neobladder: A portion of the small intestine is used to create a new bladder, which is then connected to the urethra, allowing for urination through the pen!s or vagina. [1, 7, 8, 9, 10]
• Continent Urinary Reservoir: Another intestinal segment is used to create a pouch inside the body, which is then connected to a stoma (opening) in the abdomen. Urine is drained from the reservoir using a catheter. [1, 3, 11]
• Ileal Conduit (Urostomy): A segment of the small intestine is used to create a tube (conduit) that connects the ureters to an opening in the abdominal wall. Urine passes through this opening into an external collection bag. [4, 7, 8, 11]
Potential Problems and Considerations:
• Incontinence: Some individuals may experience urinary incontinence, especially with neobladders, and may need to use a catheter to help empty the bladder or reservoir. [1, 12]
• Infections: All urinary diversions carry a risk of infection. [12, 13, 14]
• Kidney Problems: Urinary diversions can affect kidney function, potentially leading to obstruction or reflux (backflow of urine). [13, 15]
• Bowel Complications: With procedures involving the bowel, there's a risk of bowel obstruction, leaks, or other complications. [13, 15]
• Stomal Issues: Urostomies can have stoma-related complications like narrowing, leaks, or skin irritation. [13, 15]
• Emotional Impact: Bladder removal is a significant life change, and it's important to address the emotional and psychological impact of these changes. [16, 17]
Life After Bladder Removal:
• Adjusting to a New Way of Urinating: Learning to manage the chosen urinary diversion method (neobladder, reservoir, or urostomy) requires time and adjustment. [2, 8, 17]
• Support and Resources: Support groups, therapists, and organizations like the United Ostomy Associations of America can provide valuable assistance and guidance. [16]
• Lifestyle Adjustments: Depending on the chosen diversion, there may be some lifestyle adjustments needed, such as learning to empty a collection bag (urostomy) or managing catheterization (reservoir). [17, 18, 19]
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