Continent urinary reservoirの術後ケアー

Abstract

CURはQOLの点からは優れた尿路変向法であるが, 術後ケアーにおいてきめ細かい配慮が必要であり, これらを怠ると色々の合併症の起こる可能性がある.術後ケアーを綿密にすることが合併症の発生を予防する上で重要であり, それはこのタイプの尿路変向術を行う医師の責任である

Continent urinary reservoirs like the Kock pouch, Indiana pouch or Mainz pouch are constructed from the detubularized intestine. These types of urinary diversion are good in regard to the quality of life, but meticulous postoperative care is required to avoid complications. Continent urinary reservoirs have common problems of mucous secretion and absorption of urinary constituents. Irrigation of the reservoir to remove the mucous debris is important to prevent stone formation and infections. The patient should be educated to perform the self catheterization properly and the danger of over-distention of the reservoir should be stressed. Periodic endoscopy of the reservoir is important to confirm whether a stone or a tumor is present or not. Measurement of electrolytes and vitamin B12 should be performed to correct abnormalities if present.