Editing Orthotopic Urinary Diversion (section)

== Answers ==

# What are the contraindications to orthotopic urinary diversion?
## Uretherectomy indications (positive urethral margin, bladder neck tumour in women, high-grade or invasive disease distal to prostatic urethra or suspected prostatic stromal invasion invasion in men)
## Renal insufficiency (from Chapter 97)
### eGFR <45 based on 2019 AUA MIBC guidelines
### Significant proteinuria
### Unable to acidify urine pH < 5.8 after ammonium load
### Unable to concentrate urine ≥ 600 mOsm/kg after water deprivation test
## Hepatic dysfunction
## Inability or unwillingness to self-catheterize
## Insufficient bowel length
## Severe urethral stricture disease
# What electrolyte abnormality can develop in patients with renal insufficiency and neobladders?
#* Hyperchloremic metabolic acidosis
# What the possible benefit of preserving the uterus in women undergoing neobladder reconstruction?
## Reduced risk of vaginal fistula
## Improves sexual function
## Reduces risk of urinary retention
## Improved daytime continence      
# What is the target volume of a mature neobladder?
#* 300-500 mL
# Approximately how much bowel is used for a ileal neobladder vs. conduit?

#* Neobladder 60-75cm vs. 10-15cm