Nursing Care for Patients After Urostomy Surgery.

ABSTRACT: When an ostomy care nurse is not available, bedside nurses must assume responsibility for providing necessary care and educating patients who undergo a urinary diversion. However, staff nurses often lack the necessary knowledge and experience to provide the best care, rehabilitation, and patient education. This article details pre- and postoperative interventions for nurses who encounter patients undergoing urostomy surgery in order to help eliminate gaps in care, increase nurses' and patients' competence and confidence, and optimize patient outcomes and quality of life. It also includes a tear sheet that nurses can use to provide patients with the basic information and skills they need for effective self-care.

Simulation Based Educational Intervention for Enhancing Irrigation Skills of Nurses Caring for Patients With Cutaneous Continent Urinary Diversions and Orthotopic Neobladders.

PURPOSE: The purpose of this study was to investigate the effect of a nurse practitioner-led simulation-based education program on nursing knowledge and confidence in the care of patients with a cutaneous continent urinary diversion (Indiana pouch) or orthotopic neobladder. DESIGN: Single-group, before-after study. SUBJECTS AND SETTING: The sample comprised 11 RNs practicing at New York Presbyterian Hospital in New York City. Subjects were predominantly female, ethnically diverse, and held a bachelor's degree. About half of the subjects had less than 3 years of experience, and more than half reported prior experience caring for patients with a urinary diversion. METHODS: Participants completed a demographic survey, and a continent urinary diversion confidence survey and pretest measuring knowledge of nursing care of patients with a urinary diversion. Following baseline data collection, an educational session focused on the irrigation of a continent urinary diversion was made available for participants to review. An onsite simulation experience was scheduled several weeks later. Investigators provided education on proper irrigation of a continent urinary diversion and observed participants' skills when irrigating a continent urinary diversion on a high-fidelity simulated patient mannequin. The simulation intervention was followed by video replay and debrief providing feedback on each participant's performance. At the conclusion of the onsite simulation intervention, participants completed a postintervention confidence survey and a knowledge posttest related to the care of a continent urinary diversion. The Wilcoxon signed rank test was used to analyze baseline and postintervention changes in nursing knowledge and confidence. RESULTS: Participants achieved significant improvements in knowledge (P = .005) and confidence (P = .009) following the simulation-based educational intervention. CONCLUSIONS: A nurse practitioner-led simulation-based educational program for RNs caring for patients with continent urinary diversions demonstrates enhanced nursing knowledge and confidence caring for patients with continent urinary diversions. We anticipate this experience will enhance care we provided to patients undergoing cystectomy and continent cutaneous urinary diversion or orthotopic neobladder construction.

Percepção do autocuidado por homens com derivações urinárias permanentes: desafios para a prática de enfermagem / Self-care as perceived by men with permanent urinary derivations: challenges for nursing practice / Percepción de cuidado personal por hombres con derivaciones urinarias permanentes: desafios pra la práctica de enfermeira

Objetivo: compreender a percepção de homens com derivações urinárias permanentes sobre o autocuidado. Método: estudo descritivo, qualitativo, apoiado na teoria de Dorothea Orem. Realizado em um hospital universitário do Rio de Janeiro, em 2018, com 19 homens que apresentavam derivação urinária permanente, presentes no ambulatório e enfermaria de urologia. Para coleta dos dados, aplicou-se entrevista semiestruturada, transcrita e submetida à análise de conteúdo. Resultados: a análise dos dados denota ausência de conhecimento dos homens sobre a prática do autocuidado, influenciada pelas limitações da comunicação dos profissionais de saúde com esses pacientes. Conclusão: os achados revelam as vulnerabilidades em saúde e as consequências das atitudes na vida desses participantes. Destaca-se a necessidade da mudança de paradigmas, de um olhar atentivo e agir diferenciado para o enfrentamento dos desafios. A educação em saúde da população masculina é uma estratégia eficaz para estímulo do autocuidado e ações de preservação da saúde.

Objective: to understand perceptions of self-care among men with permanent urinary bypasses. Method: this qualitative, descriptive study, supported by Dorothea Orem's theory, was conducted present in the outpatient clinic and urology ward of a university hospital in Rio de Janeiro city, in 2018, with 19 men with permanent urinary diversions. Data were collected by semistructured interviews, and the transcriptions subjected to content analysis. Results: data analysis revealed the men's lack of knowledge about practical self-care, influenced by the limitations of communication between health personnel and these patients. Conclusion: the findings reveal health vulnerabilities and the consequences of attitudes in the lives of these participants. They underline the need for paradigm change, for attentive eyes and different actions to meet the challenges. Health education for the male population is an effective strategy to encourage self-care and actions to preserve health.

Objetivo: comprender las percepciones del autocuidado entre los hombres con bypass urinario permanente. Método: este estudio cualitativo, descriptivo, sustentado en la teoría de Dorothea Orem, se realizó presente en la consulta externa y sala de urología de un hospital universitario de la ciudad de Río de Janeiro, en 2018, con 19 hombres con derivaciones urinarias permanentes. Los datos fueron recolectados mediante entrevistas semiestructuradas y las transcripciones sometidas a análisis de contenido. Resultados: el análisis de datos reveló el desconocimiento de los hombres sobre el autocuidado práctico, influenciado por las limitaciones de comunicación entre el personal de salud y estos pacientes. Conclusión: los hallazgos revelan vulnerabilidades de salud y las consecuencias de las actitudes en la vida de estos participantes. Destacan la necesidad de un cambio de paradigma, de miradas atentas y de diferentes acciones para afrontar los retos. La educación en salud para la población masculina es una estrategia eficaz para fomentar el autocuidado y acciones para preservar la salud.

Effect of Ostomy Care Team Intervention on Patients With Ileal Conduit.

PURPOSE: The purpose of this study was to investigate the effect of a nurse-led multicomponent intervention on ostomy-related complications, self-efficacy, and health-related quality of life in patients with an ileal conduit. DESIGN: Randomized controlled trial. SAMPLE AND SETTING: Forty-six patients who underwent radical cystectomy and creation of an ileal conduit participated in the trial; data were collected over a 6-month period. The study setting was Shanghai Pudong Hospital, affiliated with Fudan University, located in Shanghai, China. METHODS: Participants were randomly allocated to an experimental or control group. Participants in the control group received routine care over a 6-month period following ostomy surgery, while those in the experimental group received a nurse-led, multicomponent, structured intervention delivered by an ostomy care team. The Chinese language versions of the Stoma Self-Efficacy Scale (SSES) and the City of Hope Quality of Life-Ostomy (COHQOL-O) questionnaire were used to assess self-efficacy in stoma care and health-related quality of life. Ostomy-related complications including peristomal moisture-associated skin damage and uric acid crystal deposits in the peristomal area were also assessed. Fisher's exact test was used to compare the incidence of ostomy-related complications between the 2 groups. Independent-samples t tests were used to compare SSES and COHQOL-O scores. RESULTS: No statistically significant differences were found between demographic characteristics of the control and experimental groups. After 6 months, the incidence of complications was significantly lower in the experimental group as compared to the control group (4.35% vs 30.43%, P = .047). In addition, the mean SSES score was significantly higher in the experimental group (indicating greater self-efficacy in stoma care) (107.13 ± 11.87 vs 85.65 ± 12.87, P = .000), and the mean COHQOL-O score was also significantly higher in the experimental group, indicating higher health-related quality of life (154.48 ± 16.01 vs 138.26 ± 13.42, P = .001). CONCLUSION: The nurse-led multicomponent intervention provided by the ostomy care team reduced ostomy-related complications and improved the self-efficacy level and health-related quality of life in persons with a new urostomy.

Percepção do autocuidado por homens com derivações urinárias: desafios para a prática de enfermagem / Self-care perception by men with urinary diversions: challenges for nursing practice

Trata-se de um estudo cujo objeto é o homem com derivação urinária permanente e a percepção do autocuidado. Tendo como objetivo geral: compreender a percepção de homens portadores de uma derivação urinária permanente sobre o autocuidado. E como objetivos específicos: identificar a percepção dos homens acerca do autocuidado; analisar a percepção de homens portadores de derivação urinária permanente sobre o autocuidado e discutir o impacto de uma derivação urinária permanente na vida do homem na perspectiva do autocuidado. Estudo descritivo e abordagem qualitativa, com 19 homens com derivações urinárias, a partir de 18 anos que estavam internados na unidade de urologia ou no ambulatório, de uma instituição hospitalar universitária situada no município do Rio de Janeiro. Utilizou-se como instrumento de coleta de dados a entrevista semiestruturada e para a análise dos dados foi aplicada a técnica de análise de conteúdo. Através da análise dos dados emergiram duas categorias: percepção dos homens sobre o autocuidado em decorrência da derivação urinária permanente e Os impactos da derivação urinária permanente na vida do homem e a educação em saúde nesse contexto. Os resultados evidenciam uma percepção fragmentada sobre as práticas de autocuidado com a derivação urinária permanente, influenciada principalmente pelo acesso ao conhecimento, pelo contexto cultural e pelos conflitos pessoais vividos. A análise apontou um impacto direto na rotina diária e profissional dos participantes, levando a incertezas, dúvidas e medo. Em relação as ações de cuidados diários realizados aponta-se a forte atuação da companheira, fortalecendo o cuidar feminino. Quanto ao profissional de enfermagem, destaca-se a necessidade de uma assistência qualificada, que vá além das ações tecnicistas e o seu papel no suporte das orientações necessárias ao autocuidado voltado a derivação urinária permanente. Conclui-se que a qualidade de vida do homem portador de uma derivação urinária permanente relaciona-se intimamente com o suporte profissional ofertado, com o relacionamento interpessoal vivido e como ele enfrenta as novas adaptações baseado na sua cultura e no seu contexto socioeconômico. E que a assistência de enfermagem a luz da teoria do autocuidado de Orem, fornece base para um processo de autocuidado bem sucedido e científico, através de orientações necessárias a qualidade de vida desses homens.

This is a study whose object is the men with permanent urinary diversion and the perception of self-care. With the general objective (The general objective is): to understand the perception of men with a permanent urinary shunt about self-care. And as specific objectives: to identify men's perception of self-care; to analyze the perception of men with permanent urinary diversion on self-care and to discuss the impact of a permanent urinary diversion on men's life from the perspective of self-care. Descriptive study and qualitative approach, with 19 men with permanent urinary diversions, from 18 years who were hospitalized in the urology unit or in the outpatient unit, of a university hospital institution located in the city of Rio de Janeiro. The semi-structured interview was used as a data collection instrument and the content analysis technique was applied for data analysis. Through the data analysis, two categories emerged: men's perception of self-care as a result of permanent urinary diversion and the impacts of permanent urinary diversion on human life and health education in this context. The results show a fragmented perception about self-care practices with permanent urinary diversion, influenced mainly by access to knowledge, cultural context and personal conflicts experienced. The results show a fragmented perception about self-care practices with permanent urinary diversion, influenced mainly by access to knowledge, cultural context and personal conflicts experienced. The analysis showed a direct impact on the daily and professional routine of the participants, leading to uncertainties, doubts and fear. Regarding the daily care actions performed, the companion's strong performance is shown, strengthening the female care. As for the nursing professional, the need for a qualified care that goes beyond the technicist actions stands out and their role in supporting the necessary guidelines for self-care aimed at permanent urinary diversion. It is concluded that the quality of life of the man with a permanent urinary diversion is closely related to the professional support offered, the interpersonal relationship lived and how he faces the new adaptations based on his culture and socioeconomic context. And that nursing care in the light of Orem's self-care theory provides the basis for a successful and scientific self-care process through necessary guidance to the quality of life of these men.

Care of the stoma: complications and treatments.

Quality patient education of how to care for their stoma improves patient outcomes and enhances quality of care and efficacy. There is a need for home visits to assist ostomates with rehabilitation of their stoma formation, as they often feel stigmatised and are likely to withdraw from social activities. It has previously been highlighted that community care is often the weakest link in rehabilitation, highlighting the need for effective teamwork and collaboration between stoma nurse specialists and community nurses. This article will focus on some of the more common complications of stomas which will be seen in the community setting, how to treat these conditions and when patients should be referred to the specialist stoma care nurse.

Trayectoria clínica enfermería: cistectomía radical / No disponible

Los tumores vesicales infiltrantes son la segunda neoplasia urológica en España y su tratamiento de elección es la cistectomía radical. Es una cirugía de gran complejidad que aumenta y mejora la calidad de vida de estos pacientes. Gracias al proyecto de rehabilitación multimodal del grupo ERAS, se ha protocolizado el proceso de atención a estos pacientes. Durante el periodo de hospitalización posoperatorio el equipo de enfermería desempeña un papel fundamental. Un plan de cuidados estandarizado de enfermería dará respuesta al protocolo evitando la variabilidad en los cuidados, aumentando la seguridad del paciente y mejorando la eficiencia de los procesos quirúrgicos

Muscle infiltrating bladder cancer constitutes the second urologic neoplasia in Spain and it is treated with radical cystectomy. It is a surgical procedure of great complexity which improves these patients' quality of life. Due to multimodal rehabilitation programme ERAS, the process of attention has been protocolized. During the postoperative period the nursing team performs an essential role. A standardised plan of care will provide answers to protocol while avoiding variability in the treatment and care towards the patient by improving patient safety as well as efficiency of surgical procedure

Urinary Sample Collection Methods in Ileal Conduit Urinary Diversion Patients: A Randomized Control Trial.

PURPOSE: The purpose of this study was to compare bacteriological urinalysis findings using 3 urinary sample collection methods (clean stoma catheterization, urine dripping from the stoma, urine collected from the clean urostomy pouch) in ileal conduit urinary diversion patients. DESIGN: Randomized controlled trial. SAMPLE AND SETTING: Twenty-seven patients with ileal conduit urinary diversion from an outpatient urology clinic were enrolled; 9 patients were seen twice, for a total of 36 subjects and comparisons. METHODS: Data were collected during a clinic visit by a trained research nurse. Patients were randomized into 2 groups: group A had the first urine sample collected by clean stoma catheterization, followed by sample collection by urine dripping from the stoma; group B had the first urine sample collection by urine dripping from the stoma, followed by sample collected by clean stoma catheterization. All patients had a third urine sample collected from a factory-clean urostomy pouch. Bacteriological urinalysis findings were compared among methods. Descriptive analyses were summarized using mean, percentage, and frequency. The mean ages of the patients between the groups were compared with the t test. Other between-group comparisons were performed using the Fisher exact test. Urinary culture finding differences among the same patients were evaluated using the McNemar test. Sensitivity and specificity of the different urine sample collection methods were calculated assuming urine sample collection by catheterization as a reference method. RESULTS: Uropathogen bacteria were detected in urinary culture in 16 of 36 samples (44%) collected by clean stoma catheterization, 15 of 36 samples (42%) collected by urine dripping directly from the stoma, and 13 of 35 samples (37%) collected from the clean urostomy pouch. Significant differences among the urine collection methods were not detected. Assuming catheterization as the most reliable method of sample collection, the sensitivity and specificity of the urine dripping from stoma collection method were 81.3% and 90.0%, respectively. The sensitivity and specificity of the urostomy pouch collection method were 73.3% and 90.0%, respectively. Among the same patients, there were no significant differences in the incidence of uropathogen bacteria when clean stoma catheterization was compared with urine dripping from the stoma and urostomy pouch methods. CONCLUSION: This study provides clinically relevant information regarding urine collection methods in ileal conduit patients. Urinary sample collection by urine dripping directly from the stoma or collected from a clean urostomy pouch provided similar uropathogen bacteria findings compared with sample collection by clean stoma catheterization.

Cystectomy-Enhanced Recovery Program: Nursing Implications.

Cystectomy is a complex procedure with a tenuous perioperative course. Enhanced recovery programs (ERPs) are bundle strategies, developed to enhance the recovery of surgical patients. This article outlines the components of an ERP for cystectomy patients from a nursing implementation perspective.

Cuidados de enfermería en un paciente intervenido de neovejiga ileal ortotópica tipo Hautmann. Caso clínico / No disponible

Entre las derivaciones urinarias en pacientes sometidos a una cistectomía radical por cáncer vesical infiltrante, la neovejiga ileal ortotópica, tipo Hautmann, es una excelente alternativa. Como objetivos nos planteamos: 1) exponer los cuidados de enfermería en pacientes intervenidos de cistectomía radical por cáncer vesical infiltrante a los que se les ha construido una neovejiga ileal tipo Hautmann, y 2) señalar el importante papel que juega enfermería, tanto hospitalaria como de atención primaria, en este tipo de intervención quirúrgica. Se expone un caso clínico de un paciente diagnosticado de cáncer urotelial papilar de alto grado con infiltración perineural al que se le ha construido una neovejiga. Se muestra el procedimiento seguido en el servicio, así como los protocolos empleados y actuaciones de enfermería. Como complicación presentó un íleo paralítico. La bibliografía especializada señala que el íleo paralítico es una de las complicaciones inmediatas que se da con más frecuencia en la cistectomía radical por cáncer vesical infiltrante, junto con la fístula urinaria, retención urinaria por mucus y urosepsis. Estudios de seguimientos de casos de neovejiga ileal tipo Hautmann muestran buenos resultados funcionales, una baja tasa de complicaciones, tanto inmediatas como tardías, y, sobre todo, una buena calidad de vida de estos pacientes

Orthopic ileal neobladder, type Hautmann, is currently the preferred method for urinary derivation in patients undergoing radical cystectomy for muscle-infiltrating bladder cancer. We set goals such as: 1) to supply useful information to patients with neobladder, specifically Hautmann neobladder about patients who underwent radical cystectomy due to infiltrating bladder cancer. 2) to highlight the important role that nursing staff plays by promoting quality in nursing care in this type of surgical intervention. It is described the case of a patient diagnosed with high-grade papillary urothelial carcinoma with evidence of perineural invasion. This patient underwent a radical cystectomy with neobladder reconstruction. The patient presented paralytic ileus. Paralytic ileus is a severe complication resulting from a variety of disorders, which is most commonly associated with radical cystectomy due to infiltrating bladder cancer. Other complications are urinary fistula, urinary retention due to mucus and urosepsis. Surveys aimed at monitoring the Hautmann neobladder show good functional outcomes, a low rate of complications of both immediate and late responses, and therefore, the quality of life for these patients was good

Urostomías: marcaje a medida versus complicaciones / No disponible

La atención integral a la persona ostomizada se inicia en el momento de la indicación quirúrgica invasiva de la extirpación completa de la vejiga que en determinadas patologías urológicas se indican: la cistitis, la litiasis vesical y en la gran mayoría de los tumores vesicales infiltrantes. Tras el primer contacto con el paciente, el objetivo de enfermería es proporcionar educación sanitaria y soporte emocional al paciente y/o cuidador durante todo el proceso, dar información individualizada para que recupere la autonomía lo antes posible

The treatment of ostomized patient is initiated when the bladder removal surgery has been performed in cases such as cystitis, vesical lithiasis and most of the bladder tumours. It is important that a professional nursing staff who has the very first contact with the patient radiate friendliness and concern, offer emotional support to the patient and/or caregiver and provides the patient with relevant information about the recovery process so the patient can restore autonomy

Cuidados de enfermería en la ureteroileostomía (tipo Bricker). Estudio de un caso clínico / No disponible

La alta incidencia y elevada prevalencia de casos de cáncer de vejiga, traducido ello en un creciente número de ingresos hospitalarios, hacen de esta patología un grave problema de salud pública. A pesar de la elevada incidencia, la mortalidad no es tan alta, debido a que es este un proceso oncológico en muchas ocasiones curable. El diagnóstico precoz de este proceso oncológico es el medio más eficaz de combatir el tumor, cuya capacidad de disminución se produce en una fase avanzada de su evolución. El papel de la enfermería es fundamental para el paciente de cirugía, transmitiendo información sobre el proceso y ayudándole en la adopción de actitudes positivas frente a la enfermedad

The (high incidence and) high prevalence of cases of bladder cancer are provoking an increased number of hospital admissions, making this disease a major public health problem. Despite the high incidence, mortality is not high, as this is a curable cancer process in many situations. Early diagnosis of this cancer is the most effective combat strategy, as the ability to decrease tumours occurs in an advanced stage of their development environment. The role of nursing care is essential for the surgery patient, transmitting information about the process and helping he or she in the adoption of positive attitude

Improving Self-Efficacy and Self-Care in Adult Patients With a Urinary Diversion: A Pilot Study.

PURPOSE/OBJECTIVES: To evaluate the feasibility and acceptability of a multimodality educational intervention for improving self-efficacy (SE) and self-care in patients with a new urinary diversion (UD).
. DESIGN: Two-arm randomized, controlled trial.
. SETTING: Academic medical center in New York.
. SAMPLE: 8 adults diagnosed with bladder cancer requiring UD.
. METHODS: A multimodality educational intervention consisting of video, Microsoft PowerPoint® slides, and medical illustrations was developed. SE was assessed pre- and postintervention related to care of the UD. Education scale scores provided evidence for intervention acceptability and assessment of UD self-care skills.
. MAIN RESEARCH VARIABLES: Feasibility, acceptability, results of SE, and self-care scales.
. FINDINGS: Enrollment and retention was 100%. All participants took part in every aspect of the study. No issues were apparent with administration of the study; however, a lack of self-care independence was noted between the study arms. The control group was younger in age than the intervention group.
. CONCLUSIONS: A supplemental multimethod educational intervention is acceptable in this population and feasible to integrate into hospital care or into an appropriately powered study.
. IMPLICATIONS FOR NURSING: A need exists for ongoing postdischarge support and education in this population. Additional studies are needed to determine the best approach for this.

Clinical and Economic Burden of Peristomal Skin Complications in Patients With Recent Ostomies.

PURPOSE: The purpose of this study was to estimate the risk and economic burden of peristomal skin complications (PSCs) in a large integrated healthcare system in the Midwestern United States. DESIGN: Retrospective cohort study. SUBJECTS AND SETTING: The sample comprised 128 patients; 40% (n = 51) underwent colostomy, 50% (n = 64) underwent ileostomy, and 10% (n = 13) underwent urostomy. Their average age was 60.6 ± 15.6 years at the time of ostomy surgery. METHODS: Using administrative data, we retrospectively identified all patients who underwent colostomy, ileostomy, or urostomy between January 1, 2008, and November 30, 2012. Trained medical abstractors then reviewed the clinical records of these persons to identify those with evidence of PSC within 90 days of ostomy surgery. We then examined levels of healthcare utilization and costs over a 120-day period, beginning with date of surgery, for patients with and without PSC, respectively. Our analyses were principally descriptive in nature. RESULTS: The study cohort comprised 128 patients who underwent ostomy surgery (colostomy, n = 51 [40%]; ileostomy, n = 64 [50%]; urostomy, n = 13 [10%]). Approximately one-third (36.7%) had evidence of a PSC in the 90-day period following surgery (urinary diversion, 7.7%; colostomy, 35.3%; ileostomy, 43.8%). The average time from surgery to PSC was 23.7 ± 20.5 days (mean ± SD). Patients with PSC had index admissions that averaged 21.5 days versus 13.9 days for those without these complications. Corresponding rates of hospital readmission within the 120-day period following surgery were 47% versus 33%, respectively. Total healthcare costs over 120 days were almost $80,000 higher for patients with PSCs. CONCLUSIONS: Approximately one-third of ostomy patients over a 5-year study period had evidence of PSCs within 90 days of surgery. Costs of care were substantially higher for patients with these complications.

Atención de enfermería posquirúrgica y recomendaciones al alta en pacientes intervenidos de neovejiga ileal ortotópica / No disponible

La neovejiga ileal ortotópica es una técnica de sustitución vesical, practicada en pacientes con tumores vesicales músculo-infiltrantes que precisan intervención de cistectomíaradical. La vejiga enferma es reemplazada por una neovejiga o vejiga ileal tipo Studer en la que se respeta la vía excretora natural, pudiendo entonces realizar la micción a través de la uretra, con preservación de la función renal. El paciente pasa por un proceso complejo en el que tiene que enfrentarse en primer lugar a un duro diagnóstico, someterse a una intervención quirúrgica agresiva, superar el posoperatorio y, finalmente, adaptarse a los cambios en esta nueva etapa de su vida. El papel de enfermería es un pilar fundamental para el paciente, puesto que una vez que concluya su estancia hospitalaria, este tendrá la autonomía necesaria en sus autocuidados. El avance y desarrollo de nuevas técnicas quirúrgicas representan un reto para enfermería, ya que debemos dar a nuestros pacientes los mejores cuidados basados en evidencia científica, ofreciéndoles las herramientas básicas necesarias para que alcancen así un nivel adecuado en su autocuidado, calidad de vida y detención precoz de posibles complicaciones

Orthotopic ileal neobladder is a technique of bladder substitution indicated in patients with muscle-invasive bladder cancer requiring radical cystectomy intervention. The urinary bladder is replaced by a Neobladder or Studer ileal bladder (1). Natural excretory via is respected and as a consequence, urination can be conducted through the urethra with preservation of renal function. The patient goes through a complex process consisting in facing a hard diagnosis, aggressive surgery, postoperative overcome, and finally adaptation to the changes in this new phase of his life. The role of nurses is a fundamental support for the patient, since ensure autonomy and self-caring need it once hospital staying is over. The progress and development of new surgical techniques represent a challenge for nursing, since we must give our patients the best evidence-based care; providing the basic tools necessary to reach an adequate level and in self-care, quality of life and early detection of possible complications

Cistectomía radical tipo Bricker ubicada en cuadrante izquierdo. Caso clínico / No disponible

El cáncer de vejiga es el sexto tipo de cáncer más común en los Estados Unidos, después del cáncer de pulmón, cáncer de próstata, cáncer de mama, cáncer de colon y linfoma. Es el tercer tipo de cáncer más común en hombres, pero el onceavo cáncer más común en mujeres. La cistectomía radical tipo Bricker es una técnica descrita por el doctor Bricker en 1950 y que sigue siendo una de las técnicas más utilizadas a pesar de los años transcurridos. Consiste en la creación de un conducto con un segmento aislado de íleon de unos 12 cm, anastomosando los uréteres al extremo proximal del íleon y abocando el extremo distal a la pared abdominal. Es una intervención mutilante que conlleva importantes secuelas para el paciente, tanto físicas como psicológicas, debido al trastorno de la imagen corporal, pérdida de la erección en el varón y sacrificio de la micción, entre otros. El tratamiento de los pacientes cistectomizados es un reto que afrontamos a diario en nuestro hospital los profesionales de enfermería, tanto antes como después de la intervención. En este póster queremos remarcar la importancia de la consulta preoperatoria y, dentro de ella, la importancia del marcaje del estoma. Esta intervención enfermera (aprobada por el Consejo de Enfermería en diciembre de 2014) influye favorablemente en la calidad de vida del paciente urostomizado

Bladder cancer is the sixth most common cancer in the United States, after lung cancer, prostate cancer, breast cancer, colon cancer, and lymphoma. It is the third most common cancer in men, but the eleventh most common cancer in women. Radical cystectomy Bricker is a technique described by Dr. Bricker in 1950 and remains one of the most used techniques despite the years. It involves the creation of a conduct with an isolated segment of ileum about 12 cm, anastomosing the ureters to the proximal end of the ileum and joining to the distal end of the abdominal wall. It is a mutilating intervention that has important consequences for both physical and psychological patient due to body image disorder, loss of erection in men and sacrifice of urination, among others. Treatment of patients with a cystectomy is a challenge that nurses should face every day in our Hospital, both before and after the intervention. In this poster we would like to emphasize the importance of preoperative counseling and specially the importance of marking the stoma. This nurse intervention (approved by the College of Nurses in December 2014) influences positively the quality of life of the patient ostomized