Irrigation solutions

Irrigation solutions

What is the best/safest/least expensive/practical irrigation solution for an Indiana pouch?

            My surgeon recommends sterile normal saline, which costs more than $10 per liter. One liter lasts about a week, a fair piece of change in a year -- a problem if you don’t have insurance coverage. It is sterile, with a long shelf life and it is probably the safest irrigation solution available.

            Is sterility critical? No, since the IP usually has a few benign bacteria in it, as noted in an earlier post. However, be sure to maintain every element of your irrigation – hands, catheter, irrigation solution, solution container, syringe, etc. -- scrupulously clean. You don’t want to replace the good bacteria with the bad ones.

            Does it have to be a “physiologic salt solution” like normal saline?  Normal saline is neither too concentrated nor too dilute so that it can be given intravenously. The normal urinary bladder and the bowel-become-bladder can tolerate both a concentrated (“salty”) or a very dilute urine, so tap or distilled water are both OK for irrigation. Again, the emphasis must be on near-sterility, so boil your water.