Urinary diversion after radical cystectomy
From an anatomical
standpoint three alternatives are presently used after cystectomy:
• Abdominal diversion such as uretherocutaneostomy, ileal or
colonic conduit, and various forms of a continent pouch.
• Urethral diversion which includes various forms of gastrointestinal pouches attached
to the urethra as a continent, orthotopic urinary diversion (neobladder,
orthotopic bladder substitution).
• Rectosigmoid diversions, such as uretero (ileo-) rectostomy.
Different types of segments of the
intestinal tract have been used to reconstruct the urinary tract, including the
stomach, ileum, colon, and the appendix.
Several studies have compared certain
aspects of health-related quality of life, such as sexual function, urinary
continence and body image, in patient cohorts with different types of urinary
diversion. However, further research is needed on pre-operative tumour stage
and functional situation, socio-economic status, time interval to primary
surgery, etc.
