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Any Suggestions for Choosing Nephrostomy Tubes vs. an Ileal Conduit?

Posted by bill404 @bill404, 2 days ago

I’m seeking opinions on whether I should have nephrostomy tubes for life or get an ileal conduit (urinary diversion). I’ll be 78 in April. My health is good except for a non-functioning bladder. I suffered from inadequate blood supply to my bladder for several months due to a prostate artery embolization in January 2024 that went wrong. I have had nephrostomy tubes in for almost a year. They were used to divert urine while my bladder was supposed to heal. But it did not heal. Recently my urologist decided my bladder is no longer functional. So, he suggested three possibilities. The one I have dismissed is an artificial urinary sphincter since my bladder has shrunk, and I would be having to pee almost every half to one hour. The two remaining options are the nephrostomy tubes or the ileal conduit. The ileal conduit may be better as a life time adjustment, but I fear the operation may have too many chances for problems, and I’ve been told the recovery time could be 6-12 months. I will appreciate any comments, suggestions or questions to help with my decision.

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ravna | @ravna | 2 days ago

Hi Bill404,
Each of your choices have their own pros and cons for sure.

Neph tubes: Pros-much less risky surgery, Con’s-chances they may become dislodged, higher risk of urinary and tube site infections, more cumbersome to maintain (two bags, two dressing changes, clothing concerns)

Conduit: Pros- one site, one bag, much lower chances of site infections, easier to maintain. Cons- much riskier surgery, higher risk of post op issues.

I was 16 when I got my urostomy conduit, so I recovered quickly, and I was pretty active so I would have chosen the urostomy over neph tubes, and I probably would chose it again here at 62…not sure how I’d feel if I were 78.

As a nurse, I did recently have an 80 yr old man that had a urostomy, and he did great with it.

Ultimately it’s a choice you alone can make taking into account your tolerance for risk, and the day to day lifestyle you’re looking for.

Take care and God bless!

REPLY
1 reply
bill404 | @bill404 | 1 day ago
In reply to @ravna "Hi Bill404, Each of your choices have their own pros and cons for sure. Neph tubes:..." + (show)
@ravna

Hi Bill404,
Each of your choices have their own pros and cons for sure.

Neph tubes: Pros-much less risky surgery, Con’s-chances they may become dislodged, higher risk of urinary and tube site infections, more cumbersome to maintain (two bags, two dressing changes, clothing concerns)

Conduit: Pros- one site, one bag, much lower chances of site infections, easier to maintain. Cons- much riskier surgery, higher risk of post op issues.

I was 16 when I got my urostomy conduit, so I recovered quickly, and I was pretty active so I would have chosen the urostomy over neph tubes, and I probably would chose it again here at 62…not sure how I’d feel if I were 78.

As a nurse, I did recently have an 80 yr old man that had a urostomy, and he did great with it.

Ultimately it’s a choice you alone can make taking into account your tolerance for risk, and the day to day lifestyle you’re looking for.

Take care and God bless!

Jump to this post

Thanks ravna. This is quite helpful. In your nursing experience, am I right about the 6-12 month recovery time for older people? God bless you too.

REPLY
1 reply
ravna | @ravna | 1 day ago
In reply to @bill404 "Thanks ravna. This is quite helpful. In your nursing experience, am I right about the 6-12..." + (show)
@bill404

Thanks ravna. This is quite helpful. In your nursing experience, am I right about the 6-12 month recovery time for older people? God bless you too.

Jump to this post

Barring any complications, you should be out of the hospital within a week or so, and generally it takes about 6 to 8 weeks to recover…so no, it shouldn’t take 6-12 months even for older but basically healthy people.

Finding a pouching system that works well for you may only be your main task….and that’ll depend on stoma placement and surrounding skin. If you go this route, just make sure you work with a stoma specialist before you leave the hospital, to give you the best head start.

I’d also look into medical supply stores before hand (either local or online) and find one that takes your insurance. I use Byram Healthcare online…they’re awesome.
🙂

REPLY
1 reply
bill404 | @bill404 | 22 hours ago
In reply to @ravna "Barring any complications, you should be out of the hospital within a week or so, and..." + (show)
@ravna

Barring any complications, you should be out of the hospital within a week or so, and generally it takes about 6 to 8 weeks to recover…so no, it shouldn’t take 6-12 months even for older but basically healthy people.

Finding a pouching system that works well for you may only be your main task….and that’ll depend on stoma placement and surrounding skin. If you go this route, just make sure you work with a stoma specialist before you leave the hospital, to give you the best head start.

I’d also look into medical supply stores before hand (either local or online) and find one that takes your insurance. I use Byram Healthcare online…they’re awesome.
🙂

Jump to this post

Thanks. That’s good advice.

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