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ileal conduit vs. continent diversion

2 years 8 months ago #50936 by Alan
Here is a good bookmark and summary of options: http://my.clevelandclinic.org/health/treatments_and_procedures/hic_Urinary_Reconstruction_and_Diversion

DX 5/6/2008 TAG3 papillary tumor .5 CM in size. 2 TURBS followed by 6 instillations of BCG weekly with a second round of 6 after a 6 week wait.

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2 years 8 months ago - 2 years 8 months ago #50934 by Cynthia
Sorry this took so long but welcome to our community. We have had people here over the years that would tell you that the type of diversion they have is the best. And the truth of the matter is that surveys find that most people feel that they type they have is the best choice. Having said that there are some differences in the diversions and lifestyle is an important factor. So let's suppose that a person was a good candidate for all the different diversions and that they had a surgeon that did a high number of the diversion chosen.

The ileal conduit is the diversion most done and that is for a few reasons. It is the one taught to all Urologists while in training. It requires normally the shortest time in surgery and some feel it has the least chance of having post operative complications. There are people who have an ileal and live full lives and adapt to it well. The main issue often times is finding the right appliance that fits their body type and activity level.

The Neo Bladder is of course one of the continent diversions. It seems to have a better outcome in males where as men can have problems with both hypercontinence and incontinence in woman the rates of these types of problems tend to be higher. But even if the statistics of 1/3 of woman having issues is correct it means that 2/3 have pretty good outcomes. Again a highly experienced surgeon is very important. It could well reduce complication rates but there are no large studies to proves my hypothesis.

The Indiana Pouch is another continent diversion. It is the one I have. As I was not a good candidate for a Neo Bladder it was my choice. I have had it for about eight years and have adjusted well. It is just a matter of making sure you have supplies when you travel and to keep track of time and fluid input to not have any surprises.

For people with body image concerns the Neo Bladder and the Indiana Pouch are both popular choices. My stoma is in my naval and does not show; if I had a bikini body to begin with I still would. By the way I didn't and I don't. Also both the continent diversions will have to be trained following surgery once they have healed enough. For a while it is like having a new baby but that is just for a short while. All the diversions have pros and cons but for most of us we learn how to deal well enough after surgery.

I hope that helps if you have specific questions please post them and either myself of someone else will chime in.

Good luck

Cynthia Kinsella
T2 g3 CIS 8/04
Clinical Trial
Chemotherapy & Radiation 10/04-12/04
Chemotherapy 3/05-5/05
BCG 9/05-1-06
RC w/umbilical Indiana pouch 5/06
Left Nephrectomy 1/09
President American Bladder Cancer Society

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2 years 8 months ago #50928 by roseanne1
Need to hear from people who have had either of these and how they are coping

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