In this procedure, the provider surgically removes the entire urinary bladder including extensive removal of bilateral pelvic lymph nodes, including external iliac, hypogastric, and obturator nodes. To maintain the outflow of urine he may create a ureteroileal conduit. In this procedure, he cuts a portion of the intestine known as ileum, sutures the ureters to divert urine into it, and connects the other end to the abdominal wall to create an external opening for outflow of urine. As an alternative approach to maintaining the outflow of urine, he may choose to create a sigmoid bladder. In this procedure, he replaces the bladder with a U or J shaped segment of sigmoid colon. He sutures the ureters onto this. He connects the newly made sigmoid bladder to the urethra for outflow of urine. He then sutures the cut ends of the intestine together to reestablish bowel continuity. He primarily performs these procedures to facilitate urine excretion following surgical removal of the urinary bladder due to malignancy.
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