Bladder Reconstruction Surgery (Urinary Diversions)
Reconstructing the Bladder
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.