Results 1 to 2 of 2

Thread: Has anyone had an ileocystostomy bladder surgery?

  1. #1

    Has anyone had an ileocystostomy bladder surgery?

    I've seen multiple urologists over the last 10 years or so about the fact that on a consistent basis, my SP catheter simply refuses to stop draining for no reason that anyone can seem to figure out.

    It's never because of a kink because i can check that. It's not from gunk clogging the catheter hole because it usually stops draining when my urine is most clear, not when gunk is actually in there. It's not because the catheter gets stuck against my bladder walls because i can move the catheter around and that rarely ever makes it start draining again. So on a near daily basis, once or twice a day, i have to disconnect the catheter from the the leg bag/extension tube and use an irrigation kit to siphon urine from from bladder to get things flowing again. Then things will drain fine for either a couple of hours or the rest of the day/night. I've long grown tired of this and it can lead to UTI's given i'm a quad and this siphon routine isn't easy to do with fingers that don't move.

    This urologist i saw today was the 4th or 5th one now who can't figure out what is causing this, so he recommended i see a specialist in doing the ileocystostomy bladder surgery as an option so i guess i wouldn't need a catheter anymore. Has anyone here had it done and if so, how have you felt about the results?

  2. #2
    Just over a year ago, I got a supra pubic catheter (SPC). Before I had the procedure, I talked to my regular urologist, a neurogenic bladder specialist (urologist) and my primary care physician. The procedure you are asking about was briefly discussed with all of them. I looked back into some old notes and found that ileocystostomy and ileovesicostomy are used interchangeably, so maybe a search here on the latter would yield some responses. Indeed, there are more threads discussing ileovesicostomy on Care Cure Community (CCC) as evidenced here: http://www.google.com/search?q=Ileov...ci.rutgers.edu

    The following excerpt from http://www.hindawi.com/journals/au/2009/801038/. This is an article you may want to read.
    1. Introduction
    In the 21st century, various surgical reconstructive techniques allow management of difficult clinical scenarios involving neurogenic bladder, intractable lower urinary tract obstruction, and lower urinary tract disasters such as sometimes occur after prostate cancer treatments. As a method in dealing with the worst of these problems, suprapubic diversion has progressed significantly over the past 50 years. In the 1950s, cutaneous vesicostomy evolved into ileocystostomy (which is now called ileovesicostomy), which improved the location and quality of the stoma, allowing improved patients dryness [1, 2]. During the late 1900s, cystectomy and ileal loop also became common, but likely is an unnecessarily invasive treatment for many patients nowadays. From the 1960s to 1980s, ileal loop diversion and chronic indwelling urethral catheterization were the mainstays of therapy. In the 1970s, clean intermittent self-catheterization (CIC) [3] took the forefront, but more complex techniques such as ileovesicostomy are still commonly necessary in special or refractory cases.
    2. History
    Smith and Hinman first described ileovesicostomy in 1955, using dogs and anastomosing ileum to the native bladder in situ. This allowed the bladder to act as a “continent reservoir,” which was drained volitionally through the ileal conduit instead of the urethra. They postulated that the bladder neck continence mechanism would remain, and that voiding would occur through the subject’s own detrusor contraction [1]. Of course, in humans, ileovesicostomy is designed as a completely incontinent suprapubic diversion.

    In 1957, Cordonnier described a case series of three successive patients on whom he utilized an “ileocystostomy” (aka “ileovesicostomy”) for neurogenic bladder in children suffering from meningomyelocele. In Cordonnier’s modification, the ileum was anastomosed to the bladder in a peristaltic fashion, and the urine was collected in a rudimentary urostomy bag [2].

    In more recent years, multiple authors have reported that the ileovesicostomy procedure provides an easily emptying and noncatheterizable low-pressure urinary conduit [4–7]. With ileovesicostomy, the primary objectives include establishing a vesical diversion that has a low detrusor leak point pressure (as low as 8 cm in some series) and minimal complications, thus allowing safe, lifelong, catheter-free bladder drainage [4].
    3. Indications
    There are four major reasons to consider an ileovesicostomy in the modern day.
    (1)Neurogenic bladder patients, who wish to avoid the long-term complications of chronic suprapubic or urethral catheter drainage, yet are unable or unwilling to use CIC or a continent diversion such as a continent catheterizable stoma (e.g., Mitrofanoff or Monti procedure). Ileovesicostomy may be especially indicated in those patients that also need a bladder neck closure, as patient and surgeon prefer the more reliable urinary egress provided by ileovesicostomy over Mitrofanoff, which has nearly a high chance of requiring eventual surgical revision [8].(2)Cases of intractable lower urinary tract obstruction, such as bladder neck contracture, in a patient who is unable or unwilling to have an alternative suprapubic diversion (e.g., suprapubic tube or Mitrofanoff).(3)Lower urinary tract disaster that may be caused by radiation therapy for prostate cancer (e.g., urethral stricture, and/or urethral-rectal fistula, and/or incontinence, and/or a small capacity bladder).(4)Urethrocutaneous fistula into a decubitus ulcer in a spinal cord injury patient [9].
    This article continues at the hot link given above.

    Maybe the various threads on CCC will give you some additional insights and bring more specific questions to mind.

    All the best,
    GJ

Similar Threads

  1. Bladder Asleep after surgery
    By djpudwill in forum Care
    Replies: 0
    Last Post: 06-17-2011, 10:33 AM
  2. bladder surgery?
    By lepups3 in forum New SCI
    Replies: 4
    Last Post: 09-09-2009, 09:23 AM
  3. Bladder Surgery Question
    By Minty in forum Care
    Replies: 5
    Last Post: 03-05-2005, 12:54 AM
  4. Bladder Augmentation Surgery
    By cctx61 in forum Life
    Replies: 1
    Last Post: 06-17-2003, 12:38 PM
  5. Bladder aug surgery
    By marco25 in forum Care
    Replies: 2
    Last Post: 03-18-2002, 10:00 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •