urinary diversion options

It all depends on the skill of the surgeon...if there are any complications..if you are going the conventional way, the DaVinci way, or laproscopic......and the institution involved doing the surgery. I think there's a big variance..unless you live where there is National Health Care and your cost is ZIP. Pat

Thank you for all the responses.

One thing I forgot to mention and was wondering about this. We were told that as far as cost goes, there is really very little difference between the urinary diversion methods. You would think that the neobladder surgery would take longer to perform and cost more.

I was planning on going with the NeoBladder, but because of problems during surgery I ended up with a ileal conduit instead.
I am only 48 and have had it for going on six weeks now. We have found the right fitting appliance. Since I loss quite a bit of weight since March (on purpose) I can wear my old pants with suspenders. I tried a belt but it rubbed on my stormo.

The only negative I have is the itching as the hairs grow back under the patch.

My surgeon has the Ileal stick out farther then most. Mine sticks out nearly and inch. I have tried five different pads and didn't have leaks for six days on any of them. Another thing my surgeon suggested is that I drink quite a bit of fluids each day to prevent kidney infection. Because of my liquid intake, I have to empty my bag every 2.5 hours.

Bags and pads are not cheap so that is a draw back unless you have insurance that will pick it up (Under my plan I can get 20 a month and my portion is only $16 total out of my pocket) I figure I will only use at the most eight-ten a month.

I am new to the bag and all so this is my first impressions. I am actually glad I didn't get the Neobladder now. My bag has become my friend.

Oh, and even with the ileal conduit, the surgeon was able to save the nerves. This is a wierd "thing" that my wife prefers I do not share with everyone. I only will say that it works, not the exacly the same way, but it does work.

Rick

I went with the neobladder but toyed briefly with all the other options and was mementarily attracted to the ileal conduit for the simplicity you mention. I think age has a lot to do with it as wendy says. Im 44 and wanted to be as much like before the op as I could be both in terms of peeing and erectile function. that said, there's people far older than me go with the neo. im pretty pleased with the result and, though the op is hard work and the recovery time can be long, it does pass and life gets back to normal. I've met people with all the various diversions and they all seem pretty pleased with them.

Hi,

You just may find that the majority of members on this forum that have had cystectomies have either had pouches/continent reservoirs or neobladders done and that ileal conduit recipients are in the minority here. However, I think this is due to the cross section we have, younger people, people with the means to get the latest techniques done. But I suspect that in reality there are many more "ostomates" than neobladders or pouches running around, as this is the preferred technique for the elderly and the elderly make up the majority of bladder cancer patients.

To be sure, I see that younger men are more motivated to get neobladders along with nerve sparing surgery, in the hopes of preserving erectile function.

Some people say it's simpler to have the external pouch/ileal conduit done, that it has less of a learning curve and one never needs to self catheterize. It has its own problems like skin irritation, but they do sort themselves out with time and finding the right appliance.

If you want to get more info on what its actually like to have an ileal conduit, you might do best at joining a group specific to 'ostomy' and 'urostomy' in particular.

We have quite a few pages on the main site that discusses some of the issues involved in having an ileal conduit,
blcwebcafe.org/urinarydiversions.asp
blcwebcafe.org/ilealconduits.asp and if it's not too much of an overload, there are some interesting facts about bowel sections used on the cystectomy page, towards the bottom. The amount of side effects are directly related to the length of bowel removed or used.

All the studies comparing quality of life have ended up saying that all 3 options are equally well received by patients. I suppose that is because there are choices, and patient choice is the most important thing barring unforeseen complications where someone's choice is not possible due to the location of the cancer.

All the best,
Wendy

My husband is now considering the ileal conduit. I wanted to get your input on the options.

His reasoning is for the simplicity of it, hoping that recovery time will be quicker, the learning curve will be easier, and that there could be fewer possible complications.