What is Ileal Conduit?
An ileal conduit is a surgical procedure and a most common form of urinary diversion surgery that involves putting in a system to mimic a bladder.(1) A part of the intestine is removed to create a new pathway for the urine. The piece of the intestine removed is then attached to a hole in the abdomen called a stoma. This allows urine to drain into the urostomy bag.
The ileal conduit procedure helps in passing urine even if the bladder has been removed.
The bladder is removed by the surgeon in the following conditions:
Bladder surgery may also be necessary after the spinal injury or damage to the bladder post-cancer treatment.
How is Ileal Conduit Performed?
Before the ileal conduit procedure, the person should meet the surgeon to discuss the procedure and risks if any. At this time the doctor takes the medical history and treatment history.
The person is informed not to eat or drink anything for about 6 hours before the surgery. They also advise washing with antiseptic gel before the procedure.
Some doctors also recommended taking laxatives before the ileal conduit surgery.
During the Ileal Conduit Surgery
The ileal conduit surgery takes 2-6 hours to complete and therefore, during the procedure the person is given general anesthesia. 6-8 inches of the intestine is removed during the procedure.(2) Removing this much part may not cause any effect on the person’s bowel function.
A small cut is made on the surface of the abdomen. The intestine is then attached to the ureters on one end and the stoma on the other. This forms a channel through which the urine can pass.
After the ileal conduit procedure, the person needs to stay in the hospital for at least 3 days.(3) Some people may need to stay for 7-14 days. The blood pressure, pulse, oxygen level, and body temperature are monitored.
Instructions are given to get up and move around post-surgery. This stimulates the bladder to start working again. Taking liquids is allowed a day after the procedure and can start food over the next few days.
Medications are given to stop the blood clot from forming and to prevent stomach ulcers.
Some swelling is observed in the genitals and groin post-procedure that disappears over a few weeks.
Complications of Ileal Conduit
Proper care should be taken to use the correctly sized opening for the stoma. If the opening is too tight the stoma might get damaged and a large opening may lead to leakage.
The common complications of the ileal conduit procedure include:(4)
- Sluggish Bowel: This may lead to complications or other symptoms in the bowel.
- Erectile Dysfunction: Sometime during the procedure the nerves causing erection get removed. This may lead to erectile dysfunction.
- Infection: This is a common complication of most surgeries.
- Blood Loss: If there is loss of blood even a few days after surgery, treatment may be needed.
Living With Urostomy Pouch
Living an active life with a pouch that collects urine is possible, but some changes need to be made in everyday habits.
Some people may also seek help from support groups.
Draining and Changing Pouch
It is easy to learn to fit and change the pouch. There is a need to drain the pouch several times a day or when it is 1/3rd or half full. Every 3-4 days the pouch should be changed. Before touching the stoma, it is very important to wash the hands.
Over time, draining, and changing the pouch would come into a habit.
A person can shower three days post-surgery and further every day. It is important to keep the site of the incision clean.
An ileal conduit is a procedure that is done alongside bladder removal surgery. It involves certain risks and complications. A person should contact a doctor immediately in case of post-surgery fever, severe pain, swelling all over the body, bloody or cloudy urine, chest pain, flushed skin, or dislodged stents are experienced. People can lead a full and active life with an ostomy pouch once they get adapted to living with it.