Bladder Reconstruction Surgery (Urinary Diversions)
The UW Prostate and Genitourinary Cancer Program (UWPGCP) and the University of Wisconsin Carbone Cancer Center, the state's only comprehensive cancer center, take a multidisciplinary approach to treating bladder cancer.
Reconstructing the Bladder
When the bladder is removed, surgeons use procedures known as urinary diversions to restore urinary function. Urinary diversions are done at the same time as radical cystectomy (robotic or through a traditional surgical incision).
Types of Urinary Diversion
- Ileal neobladder: Part of the ileum (small intestine) is used to make a new bladder, allowing for "normal" urination. This procedure works best on men. It provides good daytime urinary control, with about a 20 percent chance of nighttime incontinence. Some women may have trouble completely emptying the neobladder and may sometimes need to use a catheter. This technique uses about 20 inches of small intestine that is configured into a sphere. Removing this small amount of intestine has no adverse effects on bowel function.
- Ileal conduit: A piece of small intestine is used to create a "pipe" that connects ureters to the surface of the skin in the navel. Urine is directed to a urostomy bag worn on the outside of the body. It is a simple and efficient procedure, but some patients may have issues with wearing an external appliance.
- Continent reservoir: Intestinal tissue is used to create an internal pouch that is connected to the navel. The patient uses a catheter to drain the pouch. This procedure is done less frequently than the previous two.