WordNet

a turning aside (of your course or attention or concern); "a diversion from the main highway"; "a digression into irrelevant details"; "a deflection from his goal" (同)deviation, digression, deflection, deflexion, divagation
an attack calculated to draw enemy defense away from the point of the principal attack (同)diversionary attack
an activity that diverts or amuses or stimulates; "scuba diving is provided as a diversion for tourists"; "for recreation he wrote poetry and solved crossword puzzles"; "drug abuse is often regarded as a form of recreation" (同)recreation
of or relating to the urinary system of the body
of or relating to the function or production or secretion of urine

PrepTutorEJDIC

〈U〉(ある進路・目的・用途などから)そらせること《+『from』+『名』》 / 〈C〉気晴らし,娯楽 / 〈U〉注意をそらすこと;〈C〉注意をそらすもの
尿の;泌尿(ひにょう)[器]の

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/24 00:12:11」(JST)

wiki en

Urinary diversion is any one of several surgical procedures to reroute urine flow from its normal pathway. It may be necessary for diseased or defective ureters, bladder or urethra, either temporarily or permanently. Some diversions result in a stoma.

Types

Nephrostomy from the renal pelvis
Urostomy from more distal origins along the urinary tract, with subtypes including:
- Ileal conduit urinary diversion (Bricker conduit)
- Indiana pouch
Neobladder to urethra diversion

Ureteroenteric anastomosis

A common feature of the three first, and most common, types of urinary diversion is the ureteroenteric anastomosis. This is the joining site of the ureters and the section of intestine used for the diversion.

The ureteroenteric anastomosis can be created in a number of different ways. There is the option of a refluxing or a non-refluxing type, and the two ureters can be joined into the intestinal segment either together or separately. The non-refluxing type has been associated with higher incidence of ureteroenteric anastomosis stricture, and there is doubt whether it has any advantages over the refluxing type. Therefore, many surgeons prefer the refluxing type which is simpler and apparently carries a lesser degree of complications.

Refluxing techniques include the Wallace and Wallace II and the Bricker end-to-side anastomosis. Non-refluxing techniques includes the Le Duc technique.

Complications

Complications include incisional hernia, neobladder-intestinal and neobladder-cutaneous fistulas, ureteroenteric anastomosis stricture, neobladder rupture and mucous formation. Ureteral diversion can lead to normal anion gap acidosis.^{[citation needed]}

References

Hautmann R (2003). "Urinary diversion: ileal conduit to neobladder". J Urol 169 (3): 834–42. doi:10.1097/01.ju.0000029010.97686.eb. PMID 12576795.
Macaluso JN Jr. External urinary diversion: pathologic circumstances and available technology. J Endourol. 1993 Apr;7(2):131-6. PMID 8518825

External links

eMedicine: Urinary Diversions and Neobladders

UpToDate Contents

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1. 膀胱切除術後の尿路変更および尿路再建 urinary diversion and reconstruction following cystectomy
2. 尿路変更後の腎合併症 renal complications following ureteral diversion
3. 尿路上皮（移行上皮）膀胱癌のマネージメントの概要 overview of the management of urothelial transitional cell bladder cancer
4. 尿路上皮（移行上皮）膀胱癌に対する根治的膀胱全摘除術および膀胱温存治療 radical cystectomy and bladder sparing treatments for urothelial transitional cell bladder cancer
5. 男性における尿道狭窄疾患の治療 treatment of urethral stricture disease in men

English Journal

Totally intracorporeal robot-assisted radical cystectomy: optimizing total outcomes.

Collins JW1, Wiklund NP.
BJU international.BJU Int.2014 Sep;114(3):326-33. doi: 10.1111/bju.12558. Epub 2014 Mar 5.
We performed a systematic literature review to assess the current status of a totally intracorporeal robot-assisted radical cystectomy (RARC) approach. The current 'gold standard' for radical cystectomy remains open radical cystectomy. RARC has lagged behind robot-assisted prostatectomy in terms of
PMID 24224480

The role of palliative surgery in castration-resistant prostate cancer.

Piper C1, Porres D, Pfister D, Heidenreich A.
Current opinion in supportive and palliative care.Curr Opin Support Palliat Care.2014 Sep;8(3):250-7. doi: 10.1097/SPC.0000000000000078.
PURPOSE OF REVIEW: Androgen deprivation therapy with luteinising hormone releasing hormone (LHRH) analogues or antagonists represents the treatment of choice in men metastatic prostate cancer (PCA). Depending on the serum concentration of the prostate-specific antigen (PSA) nadir, the survival might
PMID 25090289

Radiation-induced hemorrhagic cystitis.

Alesawi AM1, El-Hakim A, Zorn KC, Saad F.
Current opinion in supportive and palliative care.Curr Opin Support Palliat Care.2014 Sep;8(3):235-40. doi: 10.1097/SPC.0000000000000073.
PURPOSE OF REVIEW: To better understand the mechanism of radiation-induced hemorrhagic cystitis and the advantages and disadvantages of available treatment options for bladder hemorrhage as well as preventive measures.RECENT FINDINGS: There have been several attempts recently to manage hemorrhagic c
PMID 25004179

Japanese Journal

ロボット支援膀胱全摘除術(RARC)の現状と問題点 (シンポジウム泌尿器がんの最新治療)

瀬島健裕,岩本秀人,眞砂俊彦 [他]
西日本泌尿器科 = The Nishinihon journal of urology 77(4), 136-143, 2015-04
NAID 40020432208

腸管利用膀胱拡大術後49年目に膀胱腺癌を発症した1例

木村博子,村上薫,青山輝義,河本泉,粟根雅章,河合潤,橋村孝幸
泌尿器科紀要 = Acta urologica Japonica 61(4), 167-171, 2015-04
… A deliberate procedure of urinary tract diversion was required because of the severe postoperative adhesion by the augmentation. …
NAID 120005611422

膀胱癌に対する尿路変向術の周術期にコレステロール結晶塞栓症を発症した1例

藤川祥平,井口亮,野口哲哉 [他]
泌尿器科紀要 = Acta urologica Japonica 61(3), 99-102, 2015-03
NAID 40020413727

「尿路変向術」

Urinary diversion
	Intervention
ICD-9-CM	56.71
MeSH	D014547

　　[★]

英: urinary diversion
同: 尿路変更術 (どちらかに統一して欲しい)

[show details]

尿路変向術 : 約 162,000 件
尿路変更術 : 約 172,000 件

尿路変向術

出典不明の資料 SURO.337

消化管を利用しない

腎瘻
尿管皮膚瘻

消化管を利用する

消化管の一部を切離して使用

失禁型

回腸導管
回盲部導管

禁制型(自己導尿型リザーバ)

自己導尿型代用膀胱造設術(禁制型代用膀胱)：(1)Kock pouch, (2)Indiana pouch, (3)Maintz poutch
自然排尿型代用膀胱造設術、新膀胱造設術：回腸(urethral Koch法、Hautmann法、Studer法)、上行結腸(Goldwasser法)、S状結腸(Reddy法)。合併症(尿失禁、排尿困難、(新膀胱造設に長い腸管を利用するため)ビタミンB12の欠損、高Cl性アシドーシス))