If your bladder is removed, your body develops new ways to eliminate urine, most commonly through a surgical procedure that diverts urine directly from the kidneys to an external collection pouch.
Understanding Bladder Removal (Cystectomy)
A cystectomy, the surgical removal of the bladder, is often performed due to conditions like bladder cancer or other severe bladder dysfunctions. When the bladder is no longer present to store urine, the body needs an alternative pathway for urine to exit. This is achieved through various forms of urinary diversion.
The Most Common Solution: Ileal Conduit
The most widespread method for managing urine after bladder removal is the creation of an ileal conduit. This procedure creates a new route for urine to flow out of the body.
Here's how it works:
- Intestinal Segment: A small piece of your small intestine is carefully removed and fashioned into a tube. This segment of the intestine is no longer connected to your digestive tract.
- Connecting the Kidneys: The ureters, which are the tubes that carry urine from your kidneys, are then attached to one end of this intestinal tube. This ensures that urine continues to flow from your kidneys, where it's produced, into this new conduit.
- Creating a Stoma: The other end of the intestinal tube is brought through an opening created in your abdominal wall, typically on your belly. This opening is called a stoma.
- External Pouch: A small, flat collection pouch, often referred to as an ostomy bag, is worn externally over the stoma. Urine continuously drains from the kidneys, through the intestinal conduit, out of the stoma, and into this pouch.
Daily Management of an Ileal Conduit
Living with an ileal conduit involves simple but consistent management:
- Emptying the Pouch: The collection pouch needs to be emptied several times a day as it fills with urine. This is typically done in a restroom, similar to using a toilet.
- Pouch Changes: The entire pouching system (the bag and the adhesive barrier that sticks to your skin) is usually changed every few days, depending on the type of system and individual needs.
- Skin Care: Proper hygiene and skin care around the stoma are crucial to prevent irritation and infection.
- Hydration: Staying well-hydrated is important for kidney health and to ensure a good urine output.
Key Aspects of Urinary Diversion
| Feature | Description |
|---|---|
| New Pathway | Urine is diverted from the kidneys directly to an exit point. |
| Intestinal Role | A segment of the small intestine often forms the new urinary conduit. |
| Stoma | A surgically created opening on the abdomen where urine exits. |
| External Collection | A discreet pouch is worn outside the body to collect urine. |
| Routine Management | Requires regular emptying of the pouch and hygiene around the stoma. |
While adjusting to life with an ileal conduit requires learning new routines, many individuals live full and active lives. Support and education from healthcare professionals, including ostomy nurses, are available to help with this transition.
