Just a quick comment.....a choice of which diversion to request is a highly personal one. You may make a choice but when the surgery is underway the urologist may discover that an individual's situation may make that choice impossible, with an ileal conduit being the only possibility.
As many people have posted under other threads, the MOST IMPORTANT THING is the expertise of the surgeon. You should pick one who does many of the procedures a year.....25 to 35 if possible. We have seen many examples where a patient is told that the ileal conduit is the only diversion appropriate for that patient, when the reality is that this is the only one that surgeon is competent to do!! There is a reason that many patients seek second opinions and end up having their surgery "elsewhere."
The Indiana pouch is well and thriving on the West Coast...maybe not at VA Hospitals. I know multiple people who have this diversion and have had no unexpected problems. It does require an experienced surgeon, as does the neobladder which is even more complicated.
Neobladders are great...when they work. For anatomical reasons, they are more problematic in women while men tend to have much more successful results.
So much for my "brief" comments!! Crusher, looks as if you have done your homework for the best personal choice for you. Others' mileage may vary.
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Urologists at the VA in Sacramento are telling me that the Indiana pouch procedure is almost extinct in the Western US due to so many valve issues. I have definitely decided to go with the Neo Bladder procedure, get this cancer out of my body and quickly! BCG seems like a long term commitment to never ending procedures and with the constant shortages you never know if it will be available. Hours of research, two Urologist opinions and a good friend that is a cancer researcher have been unanimous in agreement that due to wide spread high grade in situ, this is right for me. I’ll keep posting with updates throughout - this forum has been really valuable to me, thanks for the support and opinions!!
I am happy to,read your article. As I am also, new to this. Just had biopsy of my TURN operation. We traveled to Cleveland clinic last week for the surgery, 5 hours away. Today's results were not good. I also need my bladder removed. I do not want to go with BCG because does not sound good results. I am aggressive and high grade tumors. Just starting to educate myself on the different ways to urine.