How to urinate after cystectomy

After patients are diagnosed with bladder cancer, they often need surgical treatment. At this time, cystectomy will be performed. After cystectomy, patients face the problem of how to urinate. At this time, other surgical treatments are needed. The more common ones are ileal cystostomy, which is to take a section of small intestine as a channel as a medium for storing urine. In addition, ureteral abdominal wall stoma and ileal in situ cystostomy are relatively common surgical methods.

How to urinate after cystectomy

1. Ileal cystotomy

A section of small intestine is used as a channel to create an opening in the abdominal wall, and the ureter is connected to this section of small intestine. Urine flows through this section of small intestine into a urine bag outside the body.

2. Ureteroabdominal stoma

The simplest surgical method is to directly connect the ureter to a urine bag outside the body. However, since directly pulling the ureter can easily cause stenosis and possible reflux into the kidneys, there are relatively more complications. It is only suitable for patients who are too old, have very serious diseases or cannot use their intestines. The above two methods are relatively simple, but the patient has to hang a urine bag every day, which makes life very inconvenient, and the patient also smells like urine. He will inevitably receive strange looks and cannot engage in normal social activities.

3. Another method is ileal in situ bladder surgery

A section of ileum is taken to make a new bladder at the location of the original bladder. The urination method is the same as that of healthy people, but it will be relatively more difficult. Some patients may also experience urinary incontinence or difficulty urinating. This is currently the most beneficial method for patients, but the operation is relatively difficult and has high requirements for patients. For example, it cannot be performed if the tumor has metastasized to the upper urinary tract.

In addition to anesthesia evaluation, radical bladder cancer surgery usually requires intestinal radiography before surgery to evaluate whether a section of the intestine can be removed to store urine. To keep the intestines clean, the patient must fast and not drink water for two days before the operation, and only supplement nutrition through infusion. The patient must also have a bowel wash before the operation. The entire operation takes a long time, requiring 3 to 5 hours, and the patient needs to prepare 20,000 to 30,000 yuan. If an in situ cystoscopic operation is to be performed, the time and cost will be even higher.