November/December 2000

Ileal Conduit and Continent Urinary Reservoir

The ileal conduit is made by using a small segment of the small intestine and creating a stoma on the surface of the skin. The small tubes, called ureters, that drain the kidneys are connected to this small intestine. This becomes a conduit, or passageway, for urine to pass outside of the body through the stoma into a collecting pouch attached to the skin. There is no storage capacity and urine flows constantly; therefore, it is an incontinent ostomy.

The ileal conduit has both advantages and disadvantages. It is a simple surgical procedure with few complications. The major disadvantage: it necessitates the use of a collecting pouch at all times. In many parts of the world, the material required for pouching is expensive and difficult to obtain. Medically, another major concern is that the connection of the ureters to the small intestine does not prevent urine from flowing back up toward the kidney. This may lead to frequent kidney infections, stone formation, swelling and fluid collecting in the kidney and possible kidney damage or failure. Because of these problems the continent urinary reservoir has increased in popularity. Some patients who have conduits with increased kidney damage have had a conversion to a continent diversion and improvement of their kidney function.

The continent urinary diversion is a reservoir created by the surgeon. It means you have control over the release of urine, and allows the patient to empty the "reservoir"of urine by either spontaneous contraction or by self-catheterization. Therefore there is no need to wear an ostomy pouch on the abdomen. This reservoir is created from the patient's own intestines.

From Metro Maryland; via Big Country (Abilene, TX) Tomy Tabloid and Stillwater-Ponca City (OK) Ostomy Outlook June 2000, via Inside Out On-line Nov/Dec 2000.

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