QUESTIONS AND ANSWERS SURE A+
✔✔ileal/colon conduit function and management - ✔✔*functions immediately with clear
or blood tinged urine
*mucous threads are normal as the conduit was made from bowel which secretes
mucous
*empty pouch when 1/3 to 1/2 full, change every 3-7 days
*can attach to straight drainage at night/in bed for prolonged periods
✔✔ileal/colon conduit complications - ✔✔*hyperchloremic hypokalemic metabolic
acidosis
*pyelonephritis or long term kidney damage
*late onset vitamin B12 deficiency
✔✔indiana pouch location - ✔✔RLQ
✔✔indiana pouch disease and procedure - ✔✔bladder cancer, neurogenic bladder,
pelvic exenteration
reservoir is constructed from distal ileum, ileocecal valve (continence mechanism), and
portion of right colon, many variations (Mainz, Miami, Florida, Studor, Mitrofanoff - uses
appendix)
*continent urinary diversion = urine is emptied from the reservoir by catheterization
✔✔indiana pouch function and management - ✔✔*functions immediately with clear of
blood-tinged urine
*pouch capacity initially small but will expand to 300-500 mL
*post-op the pouch will have a Malecot catheter to irrigate the pouch and a Foley
catheter to drain the urine
*after pouch-o-gram to confirm healing, pt will be taught to self cath
, ✔✔indiana pouch complications - ✔✔*pouchitits (s/s: sudden explosive loss of urine,
increased mucous, abd. pain, fever, malaise)
*risk for cancer development
*risk for vitamin B12 deficiency
*hyperchloremic hypokalemic metabolic acidosis (s/t excess sodium and chloride being
absorbed by bowel mucosa
✔✔kock pouch location - ✔✔RLQ
✔✔kock pouch disease and procedure - ✔✔bladder cancer, neurogenic bladder
similar procedure to indiana pouch, but continence mechanism is a nipple valve
*continent urinary diversion = urine is emptied by catheterization
✔✔kock pouch function and management - ✔✔*functions immediately with clear to
blood-tinged urine
*pouch capacity small to begin, but will expand to 300-500 mL over time
*post-op with catheter inserted to straight drainage, once healed pt will be taught to self
cath
✔✔kock pouch complications - ✔✔*pouchitis
*25% incontinence rate due to nipple valve failure
✔✔orthotopic neobladder location - ✔✔internal, no stoma
✔✔orthotopic neobladder disease and procedure - ✔✔early stage invasive bladder
cancer
the bladder is removed and an internal pouch is constructed from segment of ileum,
pouch is located in the pelvis and attached to the urethra
*continent urinary diversion = urine is emptied through the urethra like normal
✔✔orthotopic neobladder function and management - ✔✔*post-op similar to indiana
pouch, will have Malecot catheter in place and removed once pt can empty bladder
through urethra
*will need pelvic flood muscle exercises
*pt will need to perform valsalva while voiding
*need to teach straight catheterization incase inability to empty bladder occurs
✔✔orthotopic neobladder complications - ✔✔*nocturnal enuresis
*daytime incontinence (use routine voiding schedule)
*bacteriuria
*stones