Urologic Use of Intestine

GI Anatomy

Gastric arteries

Jejunum vs Ileum

Colonic watersheds

Other notes

Neobladder patient selection, from Campbell's

Surgical planning

Choosing the right segment

Segment Advantages Disadvantages
Stomach Less permeable to solutes
Produces less mucus
Less risk for metabolic acidosis (CKD)
Hypochloremic metabolic alkalosis
Hematuria/Dysuria syndrome
Dumping syndrome
B12/Iron deficiency
Ileum Mobile
Small diameter
Constant blood supply
Hyperchloremic metabolic acidosis
B12 deficiency
Bile salt diarrhea
Fat malasorption
Cancer risk
Colon Able to reach anywhere in abdomen/pelvis
Less likely to have been irradiated
Less risk for metabolic abnormalities
Hyperchloremic metabolic acidosis
Needs mobilization
Diarrhea with removal of ileocolic valve
Cancer risk

Preoperative workup

Principles of intestinal surgery

Neurogenic bladder options

Non-orthotopic urinary diversion options

Orthotopic neobladder

Stoma tips

Ureterointestinal anastomosis

Complications

General intestinal complications

Anastomotic complications

Intestinal segment complications

Stoma complications

Ureterointestinal anastomotic complications

Metabolic complications

Neobladder complications

Sources