Diversion Options and Considerations

[Greg]

At the Toronto Patient Ed Conference on May 25 at the RC breakout group, three diversions were discussed. Unfortunately we missed out on the fourth due to time, the Mainz II, that we hear little about, but which at least one of our attendees has.
Of the three discussed, here are some potential downsides (lots of upsides for each, of course):

Ileal Conduit:
1. Need for and cost of supplies
2. Skin issues around stoma, cleaning, breakdown, hardening, discolouration
3. Occasional leakage of exterior bag

Indiana Pouch:
1. Occasional leakage
2. Need for and cost of supplies and carrying catheters
3. Catheterization mulitple times daily and at night

Neobladder
1. Incontinence, some never gain nighttime control
2. Need for and cost of undergarment protection and pads
3. No sensation of fullness

Perhaps others can add more downside. We can then go to upside!

[Sandra T]

Ok here is the down side to
Mainz 11

1. Risk of infection needing frequent or prophylactic antibiotics
2. Risk of acidosis requiring Sodium Bicarbonate pills (not an issue for me)
3. At 10 years post op the need for annual colonoscopies.

Another personal downside is the lack of knowledge of the procedure among medical professionals. Saw a gastroenterologist yesterday and he said ” you have a what and you do what.”

[KIOWA]

Good synopsis, thank you. I think I have made my mind up to have an ileal should I get to a point where I need and RC. Skin breakdown though???? Does AAA cover that at all?

Kiowa

[Greg]

Well, AAA or in our country, CAA, does cover repairing a tire and some of us do have spare tires around our waists. So I guess it would be covered. It would be what they might want to attach the jumper cables to that would frighten me.

[Author]

Posts