Urinary diversion methods suitable for bladder cancer patients

Bladder cancer is a common malignant tumor of the urinary system. In addition to the physical and mental pain that general cancer brings to patients, bladder cancer patients also face the inconvenience of urination after surgery. In order to improve the quality of life of patients, patients who have undergone radical bladder cancer surgery can find the urinary diversion method that suits them among the following three methods.

1. Ileal cystoscopic surgery: This is the simplest and most convenient method of urinary diversion. A section of the ileum is needed as an output tract to drain urine through the skin to the outside, and a stoma bag is used to collect urine. The ureter is anastomosed to the proximal end of the ileal output tract, and the distal end is sutured to the skin of the abdominal wall to form a nipple. The nipple is covered with a stoma bag to collect the outflowing urine. The patient only needs to empty the stoma bag regularly every 4-6 hours. This method is simple and beautiful, will not affect the patient's other normal life, and has a wide range of adaptability.

2. Controllable urinary diversion: A section of ileum is also required to replace the bladder, but the patient does not need to wear an ostomy bag. The urine is first drained into a sac made of ileum, and then connected to the skin of the abdominal wall through a thin tube. Then a small opening is made on the skin surface for drainage, and a catheter is inserted into the sac through the nipple of the skin of the output tract to drain the urine. This method does not require an ostomy bag, but the urine in the sac needs to be drained in time to avoid rupture of the sac.

3. New bladder reconstruction: This surgery can restore the patient's normal urination function before the surgery. It requires about 50cm-60cm of ileum to replace the bladder. First, the intestinal tube is used to make a urine storage sac, and then the ureters on both sides are implanted on the urine storage sac, and then anastomosed with the urethral stump. Similar to a normal bladder, the patient can urinate through the original urethra. Because it does not have a detrusor muscle, the patient must learn to contract the abdominal wall muscles to increase the pressure in the new bladder to urinate, and the patient needs to exercise continuously before it can be used.