Genitourinary Disorders Treatment and Nursing Implications

Common Medical Treatments for Genitourinary Disorders

• Urinary Diversion

  • Surgical diversion of ureters to abdominal wall
  • Continent diversion: uses intestine to create catheterizable bladder
  • Noncontinent diversion: stoma on abdominal wall requires ostomy pouch

• Foley Catheter

  • Indwelling catheter stays in place with inflated balloon
  • Indications: bladder failure or removal (e.g., bladder exstrophy)

• Ureteral Stent

  • Thin catheter placed in ureter for temporary urine drainage
  • Removed via cystoscopy
  • Indications: urinary tract anomalies

• Nephrostomy Tube

  • Tube into kidney for external urine drainage
  • Indications: urinary tract anomalies

• Suprapubic Tube

  • Catheter in bladder through abdominal wall above symphysis pubis
  • Indications: urinary tract anomalies

• Vesicostomy

  • Stoma from abdominal wall to bladder
  • Indications: urinary tract anomalies

• Appendicovesicostomy (Mitrofanoff Procedure)

  • Uses appendix to create stoma for bladder catheterization
  • Indications: neurogenic bladder

• Bladder Augmentation

  • Enlarges bladder capacity using stomach/intestine
  • Indications: urinary tract anomalies, neurogenic bladder

Nursing Implications

• Skin Care

  • Meticulous skin care needed to prevent stoma breakdown
  • Teach ostomy care to families

• Monitor Urine Characteristics

  • Expect mucus in urine with intestinal reservoir
  • Monitor color, clarity, consistency, and amount of urine

• Infection Monitoring

  • Watch for urinary tract infections
  • Check urinalysis and cultures

• Postoperative Care

  • Observe for urethral drainage, irritation, and bleeding
  • Monitor urine output carefully

• Diaper Use

  • Constant drainage from certain devices may require diapers

• Education

  • Teach family and child about catheterization for stoma
  • Focus on improving self-esteem through urinary continence.