Renal and urinary tract cancers a Flashcards
Urinary Tract
Cancers
- Kidney and renal pelvis
- Bladder
- Prostate gland
- Urethra
Bladder Cancer
Most common between the ages of 60-70 yrs
• More common in men than women
• Risk factors: cigarette smoking, exposure to dyes (rubber and cable industries), chronic recurrent renal calculi, chronic lower UTI’s, long term indwelling catheters
• Clinical manifestations: visible, painless haematuria; voiding changes, pelvic or back pain
• Diagnosis: cystoscopy
• Treatment: cauterisation; transurethral resection; cystectomy and urinary diversion procedures (i.e. ileal conduit); chemotherapy
Urinary Diversions
“Urinary diversion procedures are performed to divert urine from the
bladder to a new exit site, usually through a surgically created opening
(stoma) in the skin.”
Reasons for urinary diversion can include
bladder cancer or other pelvic malignancies, birth defects, trauma, strictures, neurogenic bladder,
chronic infection or intractable cystitis; used as a last resort for
incontinence.
Cutaneous
urinary
diversions
conventional ileal conduit
cutaneous ureterostomy
vesicotomy
nephrostomy
conventional ileal conduit
The surgeant transplants ureter to an isolated section of the terminal ileum, bringing one end to the abdominal wall.
cutaneous ureterostomy
The surgeon brings the detached ureter through the abdominal wall and attaches it it to an opening in the skin
vesicotomy
the surgeon suturesthe bladder to the abdominal wall and creates an opening ( stoma) through the abdominal wall for urinary damage
nephrostomy
inserts a cather into the renal pelvis via incision in the flank or by percutaneous catether placement into the kidney
Continent
Urinary
Diversions
indiana pouch
continent ileal urinary diversion
Kock pouch
Ureterosigmoidostomy
indiana pouch
introduce the ureter into a segment i an ileum or caecum. Urine is drained periodically by inserting cather into the stoma
continent ileal urinary diversion
the surgeon transplant the ureter to an isolated segment in the bowel, ascending colon or and develops an effective continence mechanism or valve.
urine is drained by insertinga cather in the stoma
Kock pouch
can be modified by attaching one end of the pouch to the urethra allowing normal voiding
Ureterosigmoidostomy
introduces the ureter sigmoid colon, therefore allowing urine to flow through the colon
Nursing Diagnoses – Urinary diversions
Preoperatively
- Anxiety
* Knowledge deficit