eMedicine Specialties > Urology > Surgery

Urinary Diversions and Neobladders: Follow-up

Author: Joseph A Costa, DO, Chief, Division of Urology, University of Florida / Shands Jacksonville
Coauthor(s): Karl Kreder, MD, Vice-Chairman, Director of Urodynamics and Reconstructive Surgery, Professor, Department of Urology, University of Iowa College of Medicine
Contributor Information and Disclosures

Updated: Dec 9, 2008

Outcome and Prognosis

Using continent reservoirs as the primary means of diversion has gained popularity since the techniques have become more refined. Patients receiving continent diversion instead of noncontinent stomas perceive themselves as having a better body image and an improved quality of life. Recent reports do not demonstrate any adverse effects on prognosis or long-term survival for patients with continent versus noncontinent diversion.

Patients with recurrent cancer do not demonstrate any difference in the occurrence of complications with regard to the type of urinary diversion used; therefore, when properly performed, either form of diversion can allow virtually equivalent outcomes and good prognosis in properly selected patients.

Future and Controversies

Cellular matrix grafts will be used as a substitute for abnormal tissue and/or to completely replace the abnormal bladder or urethra.

Cystectomy and female sexual dysfunction will become a bigger issue, and more attention will be paid to vaginal-sparing and nerve-sparing cystectomy.

Orthotopic diversion in females is gaining greater acceptance and now has fewer contraindications with regard to bladder replacement after cystectomy for malignancy.

 


More on Urinary Diversions and Neobladders

Overview: Urinary Diversions and Neobladders
Workup: Urinary Diversions and Neobladders
Treatment: Urinary Diversions and Neobladders
Follow-up: Urinary Diversions and Neobladders
Multimedia: Urinary Diversions and Neobladders
References
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References

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Further Reading

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Keywords

urinary diversion, neobladder, urinary tract diversion, urinary conduit, orthotopic diversion, continent catheterizable diversion, ostomy, stoma, ureteroproctostomy, ureterosigmoidostomy, rectal bladder, ileal loop, ileal neobladder, Koch pouch, Indiana pouch, continent diversion, noncontinent diversion, continent urinary diversion, noncontinent urinary diversion, continent urinary tract diversion, noncontinent urinary tract diversion, cutaneous ureterostomy, neobladder diversion, continent catheterizable diversion, urinary system diversion

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Contributor Information and Disclosures

Author

Joseph A Costa, DO, Chief, Division of Urology, University of Florida / Shands Jacksonville
Joseph A Costa, DO is a member of the following medical societies: American Urological Association
Disclosure: Coloplast Consulting fee None; Pfizer Honoraria None

Coauthor(s)

Karl Kreder, MD, Vice-Chairman, Director of Urodynamics and Reconstructive Surgery, Professor, Department of Urology, University of Iowa College of Medicine
Karl Kreder, MD is a member of the following medical societies: Alpha Omega Alpha and American Urological Association
Disclosure: Nothing to disclose.

Medical Editor

Erik T Goluboff, MD, Professor, Department of Urology, College of Physicians and Surgeons, Columbia University; Director of Urology, Allen Pavilion, New York Presbyterian Hospital
Erik T Goluboff, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Urological Association, Medical Society of the State of New York, New York Academy of Medicine, Phi Beta Kappa, and Society for Basic Urologic Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Dan Theodorescu, MD, PhD, Paul Mellon Professor of Urologic Oncology, Department of Urology, University of Virginia Health Sciences Center
Dan Theodorescu, MD, PhD is a member of the following medical societies: American Cancer Society, American College of Surgeons, American Urological Association, Medical Society of Virginia, Society for Basic Urologic Research, and Society of Urologic Oncology
Disclosure: Nothing to disclose.

CME Editor

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Omeros Corporation Consulting fee Consulting

Chief Editor

Bradley Fields Schwartz, DO, FACS, Associate Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine
Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Association of Military Osteopathic Physicians and Surgeons, Endourological Society, Society of Laparoendoscopic Surgeons, and Society of University Urologists
Disclosure: Nothing to disclose.

 
 
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