Continent diversions: the new gold standards of ileoanal reservoir and neobladder.
In recent decades, surgical treatment of familial adenomatous polyposis, chronic ulcerative colitis, and muscle-invasive bladder cancer has undergone a revolution. Specifically, ileoanal reservoir and neobladder have become the new "gold standard" of definitive surgical therapy for these disorders. This article discusses issues in surgical construction, indications, contraindications, perioperative care concepts, and nursing and health professional implications related to these two procedures. These interventions include screening candidates for ileoanal reservoir or neobladder to rule out Crohn's disease or metastatic cancer and educating candidates for continent diversions about the proposed procedure(s) and associated events, potential complications, postoperative exercise, sexual health and function issues, and the benefits of support group participation so they can gain a realistic understanding of ultimate functional outcomes. Questions for future research are addressed.
Beitz
Janice M
JM
Nursing Certificate and Distributive Learning Programs, School of Nursing, La Salle University, Philadelphia, PA 19141, USA. beitz@lasalle.edu.
D011125:Adenomatous Polyposis Coli / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D039021:Colonic Pouches / Q000592:standards; D006801:Humans; D008403:Mass Screening; D018579:Patient Selection; D019990:Perioperative Care / Q000379:methods / Q000451:nursing; D017410:Practice Guidelines as Topic; D016737:Proctocolectomy, Restorative / Q000379:methods / Q000451:nursing / Q000592:standards*; D001749:Urinary Bladder Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods / Q000451:nursing / Q000592:standards*