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Thread: Why are Urostomies not reversible?

  1. #1

    Why are Urostomies not reversible?

    This may be a silly question but I can't find the answer anywhere? Why are urostomies not reversible when I routinely hear of reversible colostomies? Is it because there is only so much tubing (urethers) to work with? Also, I have heard of a handful of cases where an incontinent urostomy was initially done and a continent urostomy done some years later, is this a rare occurence? Is this possible in all cases or?

    It's been proposed to me as a possibility but I really hate that this is a permanent thing and since docs are uncertain it'll help, I may be out of options if it doesn't work.

    Any ideas? SCI Nurse maybe? Thx!

  2. #2
    You hit the nail, right on the head, so to speak regarding the colostomy vs urostomy difference. It is not possible to tell you that they can make the incontinent urostomy into a continent one without knowing a lot more information. This is a question for your surgeon. Sorry I can not be more helpful.
    ckf

  3. #3
    Senior Member lynnifer's Avatar
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    This has been presented to me as an option as well. I'm wondering do they remove the bladder totally or what?
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  4. #4
    Quote Originally Posted by SCI-Nurse View Post
    You hit the nail, right on the head, so to speak regarding the colostomy vs urostomy difference. It is not possible to tell you that they can make the incontinent urostomy into a continent one without knowing a lot more information. This is a question for your surgeon. Sorry I can not be more helpful.
    ckf
    Thanks, you were quite helpful!

  5. #5
    Quote Originally Posted by lynnifer View Post
    This has been presented to me as an option as well. I'm wondering do they remove the bladder totally or what?
    Good question, from what I've heard of people who had it done due to SCI or whatever, they can either leave it or take it out (I'm guessing in cases like cancer they'd take it out, obviously). I don't see the use in leaving it in if it serves no purpose other than possibly get infected or cause more issues. But who knows. I have a list of questions for the surgeon whenever I get the chance, that'll prob be one of them!

  6. #6
    Not all colostomies can be reversed.

    For urostomies, many times they are done because the bladder needs to be removed (cancer, etc.), so obviously could not be reversed for that reason. Also, the ureters may not be long enough any more to reach the bladder if a fairly high urostomy was done, esp. if a ileal conduit. I did have one client who had his redone by using his ileal conduit converted to an augmentation of his bladder. It looks very strange when imaged, but it works, and he went back to using intermittent cath after many years of having an ileal conduit, but choice of this urinary management system should not be done with the plan that it only be temporary. These are big surgical procedures. Removing the bladder is not easy, and would make the surgery even bigger, so unless it is absolutely necessary, it is usually left in place.

    (KLD)

  7. #7
    They removed my bladder 2 weeks after my illeal conduit was done. In my case the cystectomy was more of a surgical undertaking than the conduit construction because of adhesions and other problems caused by chronic infection. The urologist concluded that leaving it in would provide a host for future infections and other problems.
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  8. #8
    Yes, each case would be decided individually.

    (KLD)

  9. #9
    Here is an instructional video re: illeal conduit. Also if you have the stomach for blood and guts do a youtube search for "illeal conduit." You will find a number of videos of the procedure. Increasingly they are doing the procedure laprascopically with robotic assistance on suitable patients. That can speed recovery because small incisions are used.

    You will find a guide to preserving shoulder function @
    http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

    See my personal webpage @
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