Decision on type of diversion for RC

hmmm..thats interesting that the nurse isn't keen on them.....well if your surgeon does the neobladder he knows how to do the Indiana....If he does neither of those he's going to sell you on the ileal conduit. The problem i keep seeing is that so many of these uros/surgeons deal with men and prostate problems and when they do see bladder cancer its usually with a male and the surgeon doesn't even second guess it if he knows how to do a neobladder. The male has a longer urethra and its much easier to hook up than a womans short urethra. I don't know the situation in Canada but in the US honestly i can name the surgeons that do the most female diversions. I guess you've just got to ask him how many he's done or even more specific how many he's done in the past year. I've only conversed with one other Canadian on cystectomy and he was not happy with the surgeon his mother was assigned to but he happened to be in a field where he had done work for a particular hospital and was able to use that leverage to get to the surgeon he wanted. Are you able to make a choice with NHC? Pat

Pat,
Thanks...it seems from all the reading/talking I've done that the Indiana Pouch is a good option, but the nurse during my preop was not keen on it, so I have to find out if that is because my surgeon doesn't do them or what...hoping to have a mtg with him soon after Christmas. I'll be back to the forum soon with more specific questions, I'm sure.
Marie

Marie...you're young, active....no question what i would go for...if your surgeon has performed lots of neobladders on women and has a good success rate i would go for it. Your other option is the Indiana Pouch. A good surgeon who does these diversions all the time will not think its complicated. Ay..there's the rub....you ideally have a surgeon who is in the OR 4 days a week and has office hours l day a week. You'll be able to accept whatever diversion. All of them can have potential problems ..with an outside bag you've got to find clothing to hide it...potential leakage...potential backup to the kidneys and UTI's...mind you i said potential. Biggest problem with neobladders for women is hypercontinence and potential UTI's. With the Indiana you have to cath but that becomes no big deal after you train the bladder...you will only empty about 4 times during the day and it has a back up valve that keeps any urine from backing up into the kidneys. If you have a good insurance plan that will pay for your catheters even better as personally i don't recommend re-using them.
Pat

Hi,
I have almost made my decision for RC (T1G3 multiple sites,>3cm, early recurrance)and I am now researchiing the type of diversion. I'm 48, 3 kids and active and my doctor assumed I would go for the neobladder, however, I think it sounds more complicated than the ileal conduit. Does anyone have any thoughts for me?
Thanks, and bless you, everyone.
Marie