Urinary diversion

A surgical procedure that reroutes the flow of urine from the kidneys. Urinary diversion is usually performed when the bladder must be removed because of cancer or a birth defect. A number of surgical procedures can be performed, depending on the abnormality and the health of the person.


One of a variety of procedures for collecting and diverting urine from its customary channel of excretion following surgical removal of the bladder for disease, usually cancer. The ureters may be implanted in the large bowel, or a reservoir or small pouch may be fashioned using a section of small or large intestine. In the latter method the pouch is emptied through a small stoma using a catheter, thus dispensing with the need for a urinary drainage bag.


Any surgical intervention, whether temporary or permanent, that facilitates the passage of urine in situations where the natural outlet of the urinary tract—via the bladder and urethra—is blocked, unusable, or in cases where the bladder has been surgically excised.


In instances where the flow of urine is impeded by factors such as an enlarged prostate gland or a narrowed urethra, a provisional alteration of urinary path might be essential. This involves inserting a tube into the bladder through an abdominal opening. Temporary diversion is also vital following certain urinary tract surgeries, where a tube is introduced into the kidney and guided to the abdominal surface.


A permanent rerouting of the urinary system becomes essential under several circumstances: after surgical removal of the bladder, in cases of profound disruption in neurological bladder control like after severe spinal injury, or when an irreparable fistula (abnormal opening) emerges between a woman’s bladder or urethra and her vagina.


A portion of the ileum, which is the lower segment of the small intestine, is excised to craft a replacement bladder. One end of this substitute bladder is utilized for implanting the ureters by the surgeon. The opposite end of the substitute bladder is subsequently brought out through an incision in the abdominal wall. To collect urine, the patient utilizes a pouch affixed to the skin.


 


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