Indiana Pouch: An Overview

A continent urine pouch constructed during a surgical procedure to create a urinary diversion is known as an Indiana pouch. This catheterize-able urine pouch restores some of the functions of the bladder.

Many conditions lead an individual to require the removal of his or her bladder. These conditions may include cancer, chronic inflammation, bladder exstrophy, spina bifida, and other diseases and injuries. After removing the bladder, the surgeon may opt to create an Indiana pouch, which is a reservoir to allow a patient to hold urine in it.

The reason we may call an Indiana pouch an alternate to a bladder is that it functions inside the abdominal wall, and it doesn’t leak out against your will. But, it doesn’t contract to push urine out of your body. You are going to have to catheterize it to draw the urine out of it. You are going to have to use a catheter for this purpose.

During surgery to create an Indiana pouch, the surgeon removes one-third of the patient’s large intestine to create a ball-like structure, which is the main reservoir. He also takes a part of the small intestine to create a valve, which serves as a channel between the Indiana pouch and the opening in the belly. This channel makes the pouch catheterize-able.

The surgeon sutures ureters to the pouch. After surgery, the urine flows into the Indiana pouch through ureters. Once the pouch is full, you need to use a catheter to draw the urine out. You may have to do it 5-6 times a day, which is pretty manageable. The part of the ileum used as a valve has sphincter muscles that prevent urine from flowing out of the pouch involuntarily.

Indiana pouch surgery

Before surgery, it is imperative to quit smoking. You may also have to increase your physical activity and take probiotics two weeks before surgery.

The surgical process may take 6-8 hours, and you may have to stay in the hospital for 3-4 days after surgery. During your hospital stay, a physiotherapist will help you engage in physical activity to prevent the formation of blood clots.

An ostomy care nurse will teach you how to take care of your Indiana pouch. He or she will tell you about how to insert catheters into the Indiana pouch.

Indiana pouch complications

Complications may arise after Indiana pouch construction surgery. Some of those complications are as follows.

• Development of blood clots and lung and heart problems
• Deficiency of Vitamin B12
• Discharge of mucus from the pouch: This problem is easily manageable by irrigation.
• Development of stones in the pouch due to incomplete drainage
• The occurrence of stoma problems, such as irritation, infection, and poor blood circulation
• Leakage of urine from the pouch during the first few months: This problem subsides over time.
• Bowel problems such as diarrhea or constipation
• Erectile dysfunction in men
• The narrowness of the vagina in women

You may want to talk to your ostomy nurse or doctor to treat or prevent such problems. A nurse will also help you with the process of learning how to use a catheter without causing any complications.