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ileal conduit

Posted By  HFHS M.D.-JL on April 14, 1999 at 10:19:33

Topic Area: Misc.
  I am a 33 year old female born with Spina Bifida.  At age 7, I underwent an ileal conduit procedure and had my bladder removed.  I have mild hydronephrosis and hydroureters, as well as stasis.  I tend to get 3-4 uti's per year which respond well to antibiotic treatment.  I would like to know if there are any things I can decrease my chances of infection besides drinking lots of fluids as my urologist recommends.  Are there any supplements I shoud take or changes in my diet that may be helpful.  My long-term concern is, of course, preservation of my kidneys.  I am undergoing an annual ultrasound which indicates my condition has been stable for the past few years.  I also am wondering what type of treatments there might be for the stasis and hydroreters, as these appear to the source of my infections.  Thanks!
1 Responses
Avatar universal

Dear Pam,
Diversion of urine using a bowel segment for an nonfunctional bladder is a common procedure.  There is frequently dilation of the ureters after the surgery is done.  Hydronephrosis, or dilation of the ureters, does not mean that there is blockage of the ureters (obstruction).  A nuclear renogram is the test to determine if blockage is present.  They can also determine if kidney function is affected or if kidney scarring is present from infection.  A urodynamic study of the loop can evaluate the pressures and capacity of the loop to see if it needs to be surgically altered to help with emptying.
Also, because your urine now travels through bowel, it is exposed to a different population of infectious organisms.  Usually, the bladder is sterile (no bugs).  The intestinal diversions however, have a large number of micro-organisms (bugs) which constantly reside there.  So when someone takes your urine specimen from the pouch it will grow out bugs .  
It is difficult to tell which organisms are just colonized there versus the bugs that are causing symptomatic infection.  If you notice blood in the urine, or have fever, chills, nausea or vomiting, chances are you have an infection that has spread to the kidneys.  This warrants treatment with antibiotics.
In addition to increasing your fluid intake, you should have a test done to make sure you don
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