Classifications of Urinary Diversions

Abstract

Advantages and disadvantages of different types of urinary diversion and their choices are of utmost importance for the functional outcome and patient satisfaction. There is a variety of choices for incontinent urinary diversion (ureterocutaneostomy, ileal conduit, colonic conduit) and continent urinary diversion (continent urinary diversion, continent cutaneous urinary diversion, and urethral bladder substitution). The choices may be limited by patient criteria and/or medical criteria. Important patient criteria are preference, age and comorbidity, BMI, motivation, underlying disease, and indication for cystectomy. PERIOPERATIVE NURSING DESCRIPTION AT BRICKER INTERVENTION/ILEAL CONDUIT Teaching the patient with a newly formed stoma, but who also has low vision to manage his/her stoma independently, can be a difficult task. Practical tips on pre- and post-operative nursing care of the patient with a newly formed stoma are provided for the nurse. In some cases, unfortunately, complications may occur following stoma-forming surgery; these are discussed and nursing advice provided. One of the most important ways in which the nurse can support the patient is to teach the patient his/her stoma care, ensuring independence before discharge and showing empathy. There is still no conclusive evidence that any type of urinary diversion offers superior HRQOL (Health-related Quality of life) outcomes. In fact, though postcystectomy patients commonly experience urinary and sexual problems, HRQOL remains good irrespective of the method of urinary diversion. Future research should utilize the validated bladder cancer specific HRQOL instruments and perhaps explore the impact of pre-operative counseling on post-operative HRQOL.