Indiana Pouch

No, It's Ronald Hrebinko.

Sorry Linda..you did mention in your first post...its not
George J. Huang, MD by any chance? I know he trained at USC/Norris which is a top bladder cancer facility.
pat

Pat,

Certainly, I'm having it done at the University of Pittsburgh Medical Center.

Linda

Linda...i just hope you're at a major university or cancer center...there are some contraindications for continenet reservoirs...and one being IBS depending on how severe it is. Many surgeons will not do it.
Contraindications
The major contraindications to urinary diversion are bowel-type specific. Because of refractory metabolic abnormalities, jejunal segments should be used only in the absence of another acceptable type of bowel segment. Bowel injured by radiation should not be used for diversion. Patients with poor renal function, severe metabolic abnormalities, and significant proteinuria should not undergo diversion with continent reservoirs. Additionally, patients who lack motivation or are unable to catheterize a continent reservoir should not undergo diversion in this manner.

Because of the potential complications of a continent reservoir versus a noncontinent diversion, the urologist must be aware of the following specific contraindications prior to performing continent diversion:

Elderly age and spinal cord injuries associated with poor hand coordination are absolute contraindications for continent urinary diversion (including neobladder) because of the need for intermittent catheterization and the potential for catastrophic complications should these individuals fail to do so.

Bowel abnormalities such as Crohn disease,
Severe Irritable Bowel Syndrome, fat malabsorption, and, potentially, ulcerative colitis preclude the surgeon from taking long segments of bowel.

Patients with a preoperative creatinine clearance of less than 60 mL/min should not undergo continent urinary diversion.
Those with a prior history of high-dose radiotherapy to the abdomen and/or pelvis should not have long lengths of small bowel used.
You may find yourself with an irritable pouch syndrome.
May i ask where you are having this done. I know a little late but i'm the devils advocate here and just wanting the best for you......Pat

Hello Linda,

I can't emphasize enough that the most important part of this surgery is the skill of your doctor (specially with an Indiana pouch). I am comforted to hear that you have checked out your surgeon so thoroughly.

No one on this forum can make a case for this surgery being any fun. Its not a walk in the park. But the right pain management will make it more tolerable.

Walk, walk, walk as soon as you can. Each day you will feel better. Don't be shy - if you need something - ask. If a nurse isn't kind to you send her packing! This is the one time when you can demand the best from others.

And know you will get through this. Just keep reminding yourself that this too will pass.

Let us know how you are doing.

Best,
Gracie

Hi Melanie,

I think I've just been overwhelmed. I start my bowel prep tomorrow for surgery Friday and the reality has certainly set in. I do have a highly recommended surgeon and I did speak with one person who he performed an RC on, although he did not have an IP. I was also made aware that while the Indiana Pouch is the intended diversion, the possibility exists that it may not happen. I have suffered from irritiable bowel syndrome but he's very hopeful that the pouch will work. There are some times I think I should have explored alternative therapies but I feel I'm up against the wall with regard to time. I also realize that some of that is due to my fears. I truly appreciate all the info everyone has provided. I also read your web site and it was truly helpful and informative. You offered to speak with me by phone, if that offer is still good, can we talk tomorrow?

Linda