Sutures and Wound Repair/ General Surgery (ABSA) Practice Test

What urinary diversion procedure is used when the bladder no longer serves as a urine reservoir?

1. Ureterosigmoidostomy

2. Ureteroneocystostomy

3. Colon conduit

4. Nephrourterostomy

The correct answer is: Ureterosigmoidostomy

The urinary diversion procedure utilized when the bladder can no longer function as a urine reservoir is ureterosigmoidostomy. This technique connects the ureters directly to the sigmoid colon, allowing urine to bypass the bladder entirely. In this way, urine is conducted through the colon and expelled from the rectum. This is particularly relevant for patients who have undergone radical cystectomy or have severe bladder dysfunction, where retaining the bladder is no longer viable. Ureterosigmoidostomy allows for the utilization of the colon to manage urine elimination effectively. Other options involve different mechanisms of urine diversion or management. For example, ureteroneocystostomy refers to reimplanting the ureters into a reconstructed bladder, which is not appropriate when the bladder is non-functional. The colon conduit involves creating a stoma in the abdomen for urine drainage but does not utilize the sigmoid colon directly as a route for urine passage. Nephrourterostomy also implies a separate management strategy that maintains the bladder's presence. Thus, ureterosigmoidostomy is the correct and preferred procedure when the bladder is inoperable or absent.