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Different bladder replacements

9 years 4 months ago #35139 by SleepyBob
Patricia wrote:

But almost everyone gets used to what they have unless a TPA agent decides to pat you down!
pat

LOL, that's what made me wonder about it. I was surprised that someone would have an external pouch when his procedure was done relatively recently. I had just assumed that was an old way of fixing the problem.

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9 years 4 months ago #35138 by Patricia
WEll if they actually told you what to expect with a neobladder instead of just saying "i think you're an excellent candidate for a neo"....of course, we would all prefer something as close to possible as our own bladder. One caveat...its really isn't..it is a "thing"...it has no nerves to signal you have to go...you may or may not be continent...you may have to catherize..but you weigh that with what you're willing to accept and do it.
As a female we have a much shorter urethra which makes for a more difficult continent issue. The Indiana is a better choice done by a incredibly great surgeon. No leakage and you train it pretty quickly to cathing 4 times a day and sleeping through the night. Plus it has a valve to prevent backup to the kidneys which keeps UTI's at bay...again if done properly. A lot of the uro's don't do it...its harder to do.
And the ileal conduit is the only one they knew how to do for a long time and its ideal for the older patient or one with other medical issues that cannot withstand a long surgery or maybe just by choice they don't want indoor plumbing.
But almost everyone gets used to what they have unless a TPA agent decides to pat you down! Many females have converted their neobladder to the ileal that are completely incontinent and completely sleep deprived.
I asked the same question when i was first diagnosed.
pat

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9 years 4 months ago #35137 by mmc
Well, if one is a woman there is a VERY strong case for an Indiana Pouch.

Depending on overall health, age, etc. one may opt for a ileal conduit.

If one doesn't want to worry about incontinent or hypercontinent, one may opt for ileal conduit because there is no continence but it goes straight to the bag anyway.

I opted for neobladder, with IP as my 2nd choice and ileal conduit as the third option. Wound up with my first choice.

What you find is that, with very few exceptions, people are happy with their choice or whatever they wound up with. Part of the reason for that (IMHO) is that is that none of the options are bad ones (with a skilled surgeon) and all of them are better than one typically expects.

IMHO = In My Humble Opinion

Mike

Age 54
10/31/06 dx CIS (TisG3) non-invasive (at 47)
9/19/08 TURB/TUIP dx Invasive T2G3
10/8/08 RC neobladder(at 49)
2/15/13 T4G3N3M1 distant metastases(at 53)
9/2013 finished chemo -cancer free again
1/2014 ct scan results....distant mets
2/2014 ct result...spread to liver, kidneys, and lymph...

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9 years 4 months ago #35134 by SleepyBob
I've read about a bunch of different types of replacements for a bladder: neobladder, ileal pouch, Indiana Pouch, urostomy bag, etc.

But what I don't understand is what determines which option would be chosen. Wouldn't everybody want a neobladder?

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