What is an Ileal Conduit?
An
ileal conduit is a type of urinary diversion procedure used when the bladder is either not functioning properly or has been removed. In this procedure, a small segment of the ileum (part of the small intestine) is used to create a conduit for urine to pass from the ureters to an external stoma on the abdominal wall.
Why is an Ileal Conduit Needed in Neonates?
Neonates may require an ileal conduit due to congenital anomalies or severe urinary tract disorders. Conditions such as
bladder exstrophy, posterior urethral valves, or neurogenic bladder dysfunction can necessitate the creation of an ileal conduit to ensure proper urinary drainage and prevent renal damage.
1. Selection of Ileal Segment: A small segment of the ileum is isolated, ensuring that its blood supply is intact.
2. Detachment and Reattachment: The isolated segment is detached from the gastrointestinal tract and its ends are reattached to maintain bowel continuity.
3. Ureteral Implantation: The ureters are implanted into one end of the ileal segment.
4. Creation of Stoma: The other end of the ileal segment is brought out through an incision in the abdominal wall to form a stoma.
- Monitoring for Complications: Such as infection, stoma stenosis, or urinary leakage.
- Stoma Care: Regular cleaning and maintenance of the stoma site are essential to prevent infection and skin irritation.
- Hydration and Nutrition: Ensuring the neonate receives adequate fluids and nutrition to promote healing.
- Infection: Both urinary tract infections and surgical site infections are possible.
- Stenosis: Narrowing of the stoma or ureteral-ileal anastomosis can occur, requiring further intervention.
- Electrolyte Imbalance: Due to the reabsorption of urine components through the ileal segment, which can disrupt the neonate's electrolyte balance.
What is the Long-term Outlook?
The long-term outlook for neonates with an ileal conduit depends on the underlying condition and the success of the procedure. Regular follow-up with a pediatric urologist is essential to monitor kidney function, stoma health, and overall growth and development. With appropriate care, many neonates can lead healthy lives.
Conclusion
An ileal conduit is a vital surgical option for neonates with severe urinary tract issues or congenital anomalies. Understanding the procedure, postoperative care, potential complications, and long-term outlook is crucial for parents and healthcare providers to ensure the best possible outcomes for affected neonates.
