A continent urinary diversion was also known as continent urinary pouch this was a type of urinary diversion. It was an alternative procedure of collecting & storing of the urine inside the body when the normal method, as explained above was failed or has been removed.
The reservoir for the urine will be made by using the bladder which was already existed or the bladder will be made bigger with the bowel or a complete new bladder was made entirely of bowel. This was connected to the outside of body by the tunnel, which will form a small opening called as stoma on the surface of the skin. This tunnel will be made of different parts like your bowel, appendix and ureter.
CONTINENT MAINZ POUCH: This was another type of the urinary diversion where after the operation patient was able to pass the urine by the rectum (the back passage). The ureters were plumbed into the rectum which was been changed surgically by that it is now a reservoir for the urine. Unlike the ileal conduit was an internal system. The main complications were:
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Incontinence: It will take many months for you to regain the continence particularly at night. Even though you will are able to tell if you need to pass the urine or if you need to have bowels open, your stool was likely to be very soft since it will be mixed with the urine. This means that you will also leak stool till you regain the control.
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Offensive odour: The bacteria which live in the bowel will provide a pungent odour which some patients will find offensive & you have to carry deodorising spray when you are using public conveniences.
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Acidosis: The bowel can absorb little amount of the urine which will makes your blood acid. This cannot give you symptoms & can easily be put right with the medication.
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Incomplete emptying: you will observe that you are incapable to empty all the contents in your rectal bladder. This will creates always have some of the urine and/or faeces in the bladder which can cause incontinence, acidosis and urine infections. If you were unable to empty the rectal bladder & as a result have acidosis and/or recurrent infections your doctor will advise you for the further surgery. This can mean changing to the another urinary diversion.
If you are experiencing problems with filling or emptying the bladder you have to remove your bladder then a continent urinary diversion will allows you to have “replacement” system formed. It can be made out of bowel or a combination of bladder and bowel. It will allow the urine to collect in that pouch till you were ready to empty it by using a plastic hollow tube known as catheter. The tube is passed into your new bladder or pouch through a narrow tunnel. The surgeon will make this out of your small bowel or your appendix. One end of this tunnel will be buried into your new bladder and the other end will be brought out on to your tummy as a continent catheterisable stoma. This means you will have an internal system to collect and store urine until you are in a position to empty yourself. There is no need to wear a bag on your tummy and as this tunnel should be dried.
