Type of Surgery
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Last updated: 02/17/2009
A number of tests are performed as part of the pre-surgery diagnostic workup for bladder conditions such as cancer, ulcerative or inflammatory disease, or pediatric abnormalities. Tests may include:
- cystoscopy (bladder inspection with a...
laparoscope) - CT scan
- liver function
- renal function
- rectal sphincter function evaluation (The rectal sphincter will be a critical ingredient in urination after the surgery, and it is important to determine its ability to function. Adult patients are often asked to have an oatmeal enema and sit upright for a period of time to test sphincter function.)
In adult patients, a discussion of continent diversion is conducted early in the diagnostic process. Patients are asked to consider the possibility of a conduit urinary diversion if the ureterosigmoidoscopy proves impossible to complete. Educational sessions on specific conduit alternatives take place prior to surgery. Topics include options for placement of a stoma, and appliances that may be a part of the daily voiding routine after surgery. Many doctors provide a stomal therapist to consult with the patient.
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Ureterosigmoidoscopy is a surgical procedure that treats urinary incontinence by joining the ureters to the lower colon, thereby allowing urine to evacuate through the rectum.
The surgical techniques for urinary and fecal diversion fall into two categories: continent diversion and conduit diversion. In continent diversion, an internal reservoir for urine or feces is created, allowing natural evacuation from the body. In urinary and fecal conduit diversion, a section of existing tissue is altered to serve as a passageway to an external reservoir or ostomy. Both continent and conduit diversions reproduce bladder or colon function that was impaired due to surgery, obstruction, or a neurogenically created condition. Both the continent and conduit diversion methods have been used for years, with advancements in minimally invasive surgical techniques and biochemical improvements in conduit materials and ostomy appliances.
From http://www.healthline.com/galecontent/ureterosigmoidoscopy
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As a urologist, I've found it's easier to do the PSA test and then sit down with the patient and say here's what the results mean for you. Given what we know right now, that seems a very sensible approach.
-Dr. Evan Vapnek
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