两分钟带你了解膀胱切除术

两分钟带你了解膀胱切除术西水东 作者：医学镜界 编者按 本期继续为大家分享欧洲泌尿外科学会视频——膀胱切除术，包括回肠膀胱术与原位新膀胱术两种，帮助病人将肾脏产生的尿液排出体外，本动画片生动形象地展示了

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作者：医学镜界

编者按

本期继续为大家分享欧洲泌尿外科学会视频——膀胱切除术，包括回肠膀胱术与原位新膀胱术两种，帮助病人将肾脏产生的尿液排出体外，本动画片生动形象地展示了膀胱切除术整个过程。同时附上英文资料，以供大家更好地学习、交流。

医生建议患者将膀胱切除，这种手术叫“膀胱切除术”。男性的膀胱全切术包括切除前列腺，女性的膀胱全切术一般包括切除子宫、卵巢以及部分阴道。切除膀胱时，医生需将输尿管与膀胱分离，输尿管即连接肾脏与膀胱，用于输送尿液的管道。手术还需要将尿道与膀胱分离，尿道即从膀胱通向体外的管道，用于排尿。这一手术中，可能也会切除淋巴结。膀胱切除后，医生需要为病人设置新的引流装置，帮助病人将肾脏产生的尿液排出体外。

本动画展示了两种常用的排尿方法：回肠膀胱术与原位新膀胱术。

第一种：回肠膀胱术

回肠膀胱即重新设置一个排尿导管，利用患者体内一段回肠进行手术，导管一端连接输尿管，即连接肾脏，用于输送尿液的管道，另一端连接肚子上的切口，学名“造口”或“腹壁造口”，尿液积聚到连接在造口上的挂袋上，挂袋中尿液积满后需手动清空，医生会指导病人学习如何倒挂袋。

第二种：原位新膀胱术

原位新膀胱术或“新膀胱”是缝合患者本身的一段小肠放在原膀胱的位置，存储尿液。新膀胱的一端连接输尿管，另一端连接尿道，与原膀胱一样，尿液通过尿道排出体外。

医生或专业护士会在患者出院后继续提供护理指导，包括指导患者应对在尿流改道后带来的新出现的问题与挑战。

English Subtitles

Your doctor has recommended that your bladder be removed.This surgery is called a “cystectomy”.In men, complete bladder removal includes removal of the prostate.In women, complete bladder removal typically includes removal of the uterus, ovaries and part of the vagina as well.To remove the bladder, the surgeon must separate both ureters from the bladder,the tubes that carry urine from the kidneys to the bladder.The surgeon will also separate the urethra from the bladder.The urethra carries urine from the bladder, out of the body.During the procedure, the lymph nodes may be removed as well.Once the bladder is removed, the surgeon will need to make a new way for passing urine from the kidneys to the outside of your body.

This animation show the two most common ways to pass urine: the ileal conduit and the neobladder.

Type 1. The ileal conduit

The ileal conduit is a new tube to carry urine.It is made from a section of your intestine.The conduit runs from the ureters, the tubes that carry urine from your kidneys,to an opening in your belly called a “stoma” or a “urostoma”.Urine is collected in a small bag placed over the stoma.The bag will need to be emptied when it is full.You will be given instructions on how to change the bag.

Type 2. The neobladder

A neobladder or “new bladder” is a pouch created from a portion of your intestines to store urine inside your body.The ureters are connected to one end of the neobladder.The urethra connects to the other end, just like in your original bladder.

You will pass urine through the urethra.

Follow-up care is provided by your doctor or a specialist nurse after you leave the hospital.This will include educational lessons on hope to cope with the challenges that come with a urinary diversion.

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