Artificial bladder

introduction

Different diseases can cause the body's urinary bladder to pass through a artificial bladder needs to be replaced. The insertion of an artificial bladder is one highly complex urological surgery.

In medicine one speaks of one artificial urinary diversion, in which the body's own bladder is replaced by various methods and the urine is passed out of the body via other routes. Depending on the surgical method, different sections of the intestine use a to form new bubble, what the function of the old bladder, that Collection and discharge of urine, can take over. What kind of artificial bladder depends on the underlying illness and previous illnesses and can best be discussed individually with the attending physician.

to form

There are a number of different forms and options artificial bladder to form and with this to replace the original bladder. Which of the options is used individually is decided in addition to the underlying disease Patient preference.

Generally, a continents and an incontinent urinary diversion can be distinguished. Depending on the type of urinary diversion, different options for the operation are possible.

The continent urinary diversion is so called because the Urine drained at will can be. A artificial bladder, those who Possibility of continence is the ideal shape. If, for example, the bladder formed from intestinal sections is connected to the ureters and the urethra, a continent urinary diversion is given. Also a so-called Pouch represents a continent form of an artificial bladder. Here the urine is either with the help of a Valve over the abdominal wall drained or directed into the intestines. The latter is only with one adequate functioning sphincter possible.

Face it incontinent forms one artificial bladder. This is where the body's own bladder is used alone replaced by a small piece of intestinewhich directs the urine through the abdominal wall to the outside into a bag. With this as Conduit designated form of urinary diversion, the bladder is not replaced by the formation of a reservoir in the body, but the Urine collects in a pouch outside the body.

causes

A number of medical conditions can involve replacing the bladder with one artificial bladder make necessary. This is always necessary when the body's own bladder is no longer able to carry out the task of collecting urine correctly or when it is in the Must be taken in the course of an illness.

For example, cancer of the bladder can result in the removal of the urinary bladder. To prevent the growth and formation of metastases, the Bladder removed when some tumors were found. However, not every tumor of the bladder requires removal of the bladder and thus the creation of an artificial bladder.

Also at congenital diseases artificial bubbles are used. This is the case, for example, with people suffering from the disease of a so-called "open back"(Medical: Spina bifida, meningomyelocele) often have to remove the bladder and use a artificial bladder to replace.

A Occlusion of the urethra, which occurs either congenitally or in the course of life, can lead to a artificial bladder must be used and replace the body's own.

The Urinary bladder can be so badly damaged by radiation therapy that as a result of the therapy a artificial bladder must be used. Especially at Tumor diseases of the bladder this is more common with radiation therapy.

From intestines

A artificial bladder is usually formed from different sections of the intestine. Depending on the type of urinary diversion chosen, different parts of the intestine are used.

With different cutting techniques can from the elongated intestine section, which for the artificial bladder used a more or less round reservoir be shaped, which as Bladder replacement acts. The missing piece of intestine can through the remaining intestinal sections in its Function replaced which is why treated patients only few side effects of bowel function experience.

Since the intestine does not normally act as a urine reservoir, the use of intestinal sections for the artificial bladder nevertheless complications. For example, it can be too malignant changes in the intestines used come. The bladder must also emptied more often as the intestine in contrast to the bladder becomes clear less elastic is.

In the end, however, the intestine continues to be the material of choice for artificial urinary diversion.

With woman

The Urinary tract anatomy differs between men and women. It so happens that the nature of the artificial bladder, which is used by women and men, has some differences. In addition to other points, the urethra in men and women is particularly different in their length. This leads to an increased likelihood of Urinary tract infections. Since it was found that at the female urethra even after the tumor has been removed, a recurrence often occurs, this is often removed when the bladder is removed.

As a result, the use of a artificial bladder, which is connected to the urethra and thus represents a continent urinary diversion Women performed less frequently. For this reason, the creation of a pouch or conduit is usually the method of choice for women after the bladder has been removed.

After cancer

One of the most common causes for the installation of a artificial bladder is the creation of a Urinary tract tumor. In addition to tumors of the urinary bladder itself can also Urethral tumors entail the removal and replacement of the bladder. Crucial for choosing which one artificial bladder individually, is always the type of tumor and its aggressiveness. The degree of progression also influences the therapy options. Next to the Insertion of an artificial bladder other treatment options may be used first. An attempt can be made to scrape out tumor cells from the inside. Radiation or chemotherapy of tumors limited to the urinary tract is also possible.

What kind of artificial bladder If the bladder is removed due to a tumor, it must be decided on an individual basis. Often the onset of a artificial bladder possible from sections of the small intestine. Other existing illnesses and previous illnesses as well as the situation during the operation influence the Choice of urinary diversion however decisive.

surgery

A artificial bladder is always used by surgery. In the operation of a artificial bladder is it a complex urological intervention. The treating surgeon and his team can provide detailed information about the measure and its alternatives. Are specialists in performing such an operation Specialists in urology.

First of all, the body's own bladder removed become. Then, based on the individual situation, it is decided whether the previously chosen choice of bladder replacement is feasible. The Structure of the intestine and the anatomical situation of the urinary tract are decisive for the decision-making of the surgeon. After the old bladder has been removed, the required section of intestine is removed and thoroughly cleaned. Using various cutting techniques, the bladder is now formed from the section. The ureters, which drain the urine from the kidney, must then be sewn to the new bladder. Depending on the choice of derivation, the urethra can now be sewn to the reservoir or another section of the intestine is used, which diverts the urine to the abdominal wall.

forecast

The prognosis depends largely on the existing diseases as well as the Reason for performing the operation from. Generally, after inserting the new bladder, a Series of complications arise, which is why a close inspection by the attending physician is recommended. It can Urinary tract and kidney infectionsso-called stenoses (occlusions) of the exit point (in pouch operations) or Tumors on the artificial bladder occur. In general, however, the situation after performing a urinary diversion is due to the onset of the artificial bladder better than before. Patients experience only one certain restriction in quality of life and usually no limitation of life expectancy.