- Urinary diversion
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Urinary diversion Intervention ICD-9-CM 56.71 MeSH D014547 Urinary diversion is any one of several surgical procedures to reroute urine flow from its normal pathway. It may be necessary for diseased or defective ureters, bladder or urethra, either temporarily or permanently. Some diversions result in a stoma.
Contents
Types
- Ileal conduit urinary diversion (Bricker conduit)
- Indiana pouch
- Neobladder to urethra diversion
- Ureterocutaneostomia
Ureteroenteric anastomosis
A common feature of the three first, and most common, types of urinary diversion is the ureteroenteric anastomosis. This is the joining site of the ureters and the section of intestine used for the diversion.
The ureteroenteric anastomosis can be created in a number of different ways. There is the option of a refluxing or a non-refluxing type, and the two ureters can be joined into the intestinal segment either together or separately. The non-refluxing type has been associated with higher incidence of ureteroenteric anastomosis stricture, and there is doubt whether it has any advantages over the refluxing type. Therefore, many surgeons prefer the refluxing type which is simpler and apparently carries a lesser degree of complications.
Refluxing techniques include the Wallace and Wallace II and the Bricker end-to-side anastomosis. Non-refluxing techniques includes the Le Duc technique.
Complications
Complications include incisional hernia, neobladder-intestinal and neobladder-cutaneous fistulas, ureteroenteric anastomosis stricture, neobladder rupture and mucous formation.
See also
References
- Hautmann R (2003). "Urinary diversion: ileal conduit to neobladder". J Urol 169 (3): 834–42. doi:10.1097/01.ju.0000029010.97686.eb. PMID 12576795.
- Macaluso JN Jr. External urinary diversion: pathologic circumstances and available technology. J Endourol. 1993 Apr;7(2):131-6. PMID: 8518825
External links
Urologic surgical and other procedures (ICD-9-CM V3 55-59+89.2, ICD-10-PCS 0T) Kidney Nephrostomy (Percutaneous nephrostomy) · Nephrotomy · Endoscopy (Nephroscopy) · Renal biopsy · Nephrectomy · Kidney transplantation · NephropexyUreter Urinary bladder Urethra General Medical imaging: Pyelogram (Intravenous pyelogram, Retrograde pyelogram) · Kidneys, ureters, and bladder x-ray · Radioisotope renography · Cystography · Retrograde urethrogram · Voiding cystourethrogram
Urodynamic testing (Cystometry)
Urinary catheterization · Dialysis
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