BLADDER CANCER

Continent Urinary Diversion powerpoint description

Removal of section of ileum Ureters attached posteriorly A pouch is created with nipple valves to prevent leakage Client must self catheterize every 2-4 hours

Ileac Conduit Procedure

Removal of section of ileum conduit (has mucosa) Ureters attached posteriorly Anterior section brought thru abdominal wall and stoma created Continuously drains urine Requires external appliance

Continent Urinary Diversion

A portion of the stomach, colon, or small intestine is used to form a reservoir to which the ureters are attached. Nipple valves are formed to prevent reflux. A nipple valve and stoma may be formed or the pouch may be attached to the urethral stump, avoiding creation of a stoma.

Bladder Cancer: Diagnostic Tests

*Urine cytology* - done to evaluate for hematuria. Gross or microscopic hematuria is often the first indicator of a neoplasm in the urinary tract. *Bladder ultrasound* - to see tumors on bladder wall *IVP* *Cystoscopy* - allow direct visualization, assessment, and biopsy of lesions of the urethra, bladder, or ureters to provide definitive diagnosis of urinary tract tumors.

Bladder Cancer: Risk Factors

*cigarette smoking* environmental carcinogens: dyes rubber leather paint ink Chronic UTI's, cystitis

Bladder Cancer Treatment cystectomy

surgical removal of the bladder, is necessary to treat invasive cancers. Partial cystectomy may be done to remove a solitary lesion; however, radical cystectomy is the standard treatment for invasive tumors. Men: the prostate and seminal vessels are also removed, resulting in impotence. Women: a total hysterectomy and bilateral salpingo-oophorectomy (removal of the uterus, fallopian tubes, and ovaries) accompanies the procedure, causing sterility.

Bladder Cancer: studies

90% of all urinary tract cancers occur in the bladder When treated early, there is a 94% five year survival rate Bladder cancer is more common in men

Bladder Cancer Treatment Depends on Stage of Tumor

Chemo wash of bladder wall Surgery: cystectomy with creation of an stomal drainage: take bladder out - proximal tumors Ileal conduit - take section from intestines to make a fake bladder (phantom bladder) Continent urinary diversion

Ileac Conduit Procedure nursing management

Most common urinary diversion. Continuous urine drainage necessitates appliance. Postoperative edema may interfere with urine output. Risk of infection is less than for cutaneous ureterostomy, but potential for reflux is high; prevent urine reflux. Empty appliance q2h or when 1/3 full. Special bedside drainage at night Good skin care vital because of constant contact with urine. Same issues as intestinal ostomy Risk for U.T.I. Educate on early detection of U.T.I. (fever, foul smelling urine) Push fluids Clean technique at home Aseptic in hospital

Bladder Cancer: Patho

Most urinary tract malignancies arise from epithelial tissue. Transitional epithelium lines the entire tract from the renal pelvis through the urethra. Carcinogenic breakdown products of certain chemicals and from cigarette smoke are excreted in the urine and stored in the bladder, possibly causing a local influence on abnormal cell development.

Bladder Cancer: Signs and Symptoms

Painless hematuria (hg will b low) S&S of UTI - Painful urination Urinary frequency Urinary urgency Urine leakage (incontinence)

Bladder Cancer Treatment Ileal Conduit

portion of ileum is isolated from small intestine, leaving vascular, lymphatic, and neural connections intact; ileum is formed into pouch with open end brought to surface to form a stoma; ureters are inserted into pouch.