PT considerations for urologic, colorectal, abdominal surgeries

urostomy

rerouting urine away from bladder by moving termination of distal ureters to outside body via stoma

ileal conduit most common - takes part of ileum out

neobladder

urine rerouted internally with intestinal piece sewn to connect kidneys to urethra

most invasive

increases QOL bc pt can have bladder retraining

pelvic splanchnic and hypogastric nerves innervate

prostate

bladder

detrusor muscle

pudendal nerve innervates

motor to external anal and urethral sphincters

sensory innervation to genitalia

crohns disease

chronic inflammatory disorder of all layers

significant weight loss

fistulas common

ulcerative colitis

chronic inflammatory disorder of mucosal and submucosal lining

effects large intestine

severe diarrhea due to water not being able to be absorbed

what side is the ileostomy stoma on

right side

function of the ileum

important for absorption and production of nutrients such as B12

emergency s/sx for ileostomy

excessive emesis

absent flatus

absent bowel activity

where is the colostomy placed

above the groin on the left

ileal-anal pouch (J-pouch)

excision of entire colon and rectum, pouch constructed from ileum then connected to anus

stoma closed at 3-6 mo and pt able to eliminate through anus

hartmann’s procedure

rectum sealed off, colostomy created

surgical resection of a colorectal mass

whipple procedure

used to remove cancerous tumors located in head and neck of pancreas

remaining pancreas and digestive organs reconnected