Urostomy

This is a general term for a surgical procedure which diverts urine away from a diseased or defective bladder. The ileal or cecal conduit procedures are the most common urostomies. Either a section at the end of the small bowel (ileum) or at the beginning of the large intestine (cecum) is surgically removed and relocated as a passageway (conduit) for urine to pass from the kidneys to the outside of the body through a stoma. It may include removal of the diseased bladder.

Continent Urostomy

There are two main continent procedure alternatives to the ileal or cecal conduit (others exist). In both the Indiana and Kock Pouch versions, a reservoir or pouch is created inside the abdomen with a portion of either the small or large bowel. A valve is constructed in the pouch and a stoma is brought through the abdominal wall. A catheter or tube is inserted several times daily to drain urine from the reservoir.

Indiana Pouch

The ileocecal valve that is normally between the large and small intestines is relocated and used to provide continence for the pouch which is made from the large bowel. With a Kock Pouch version, which is similar to that used as an ileostomy alternative, the pouch and a special "nipple" valve are both made from the small bowel. In both procedures, the valve is located at the pouch outlet to hold the urine until the catheter is inserted.