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Urinary diversion - Coggle Diagram
Urinary diversion
Complications
- Urinary Leakage: One of the most common complications associated with urinary diversion is urinary leakage, which can occur due to a variety of factors, such as surgical technique, wound healing, or infection.
- Urinary Tract Infections: Urinary tract infections are a common complication of urinary diversion, as the diverted urine can become stagnant and provide a breeding ground for bacteria.
- Urinary Stone Formation: Urinary stone formation is a common complication of urinary diversion, as the diverted urine can become concentrated and promote stone formation.
- Urinary Obstruction: Urinary obstruction is a common complication of urinary diversion, as the diverted urine can become obstructed due to scar tissue, strictures, or other factors.
- Urinary Incontinence: Urinary incontinence is a common complication of urinary diversion, as the diverted urine can become uncontrollable due to nerve damage or other factors.
- Urinary Retention: Urinary retention is a common complication of urinary diversion, as the diverted urine can become retained due to nerve damage or other factors.
- Intestinal Obstruction: Intestinal obstruction is a rare but serious complication of urinary diversion, as the diverted urine can become obstructed and cause intestinal obstruction.
Contraindications
- Severe Cardiac or Pulmonary Disease: may not be good candidates for urinary diversion due to the high risk of complications associated with major surgery.
- Severe Coagulopathy: as hemophilia or liver disease, may not be good candidates for urinary diversion due to the increased risk of bleeding during surgery.
- Severe Malnutrition: may not be good candidates for urinary diversion due to the increased risk of complications associated with major surgery in the presence of malnutrition.
- Severe Renal Impairment: may not be good candidates for urinary diversion due to the increased risk of complications associated with major surgery in the presence of renal impairment.
- Severe Psychological or Cognitive Impairment: may not be good candidates for urinary diversion due to the need for ongoing management and care after the procedure.
Indications
- Bladder Cancer: Urinary diversion is often necessary for individuals with bladder cancer that has spread to the bladder wall or cannot be removed through surgery. This is because the cancer cells can grow into the bladder and cause blockages, which can lead to urinary tract infections and other complications.
- Bladder Dysfunction: Urinary diversion may be necessary for individuals with bladder dysfunction, such as neurogenic bladder, which is caused by nerve damage or injury. This can result in urinary incontinence, frequent urination, and urinary retention.
- Spinal Cord Injuries: Urinary diversion may be necessary for individuals who have suffered spinal cord injuries that have resulted in bladder dysfunction. This can help prevent urinary tract infections and other complications.
- Birth Defects: Urinary diversion may be necessary for individuals who were born with birth defects that have affected the urinary tract, such as bladder exstrophy or cloacal exstrophy. This can help prevent urinary tract infections and other complications.
- Radiation Therapy: Urinary diversion may be necessary for individuals who have undergone radiation therapy for cancer treatment, as this can cause damage to the bladder and urethra. This can lead to urinary tract infections, urinary incontinence, and other complications.
Types
- Ileal Conduit: the most common type of urinary diversion. The surgeon creates a new pathway for urine to exit the body using a section of ileum. The ureters, are connected to the ileum, and the remaining end of the ileum is brought out through the abdomen as a stoma. Urine then drains into a collection bag attached to the stoma.
- Continent Urinary Diversion: This type of diversion allows the patient to store urine in a pouch created from a section of the intestine. The ureters are connected to the pouch, and the patient can empty the pouch using a catheter. This type of diversion eliminates the need for an external collection bag, which can improve body image and self-esteem.
- Cutaneous Ureterostomy: This type of diversion involves creating a new opening in the abdomen for each ureter to exit separately. The ureters are connected directly to the skin, and urine drains out of the openings. This type of diversion is less common than the other two because it can result in more frequent urination and urinary leakage.
- Orthotopic Neobladder: This type of diversion involves creating a new bladder from a section of the intestine and connecting it to the urethra. The ureters are connected to the new bladder, and the patient can urinate normally through the urethra. This type of diversion is less common than the other types because it is more complex and requires specialized surgical skills.
Urinary diversion is a surgical procedure that creates a new pathway for urine to exit the body when the normal urinary tract is unable to function properly. This can be due to conditions such as bladder cancer, bladder dysfunction, spinal cord injuries, or birth defects.