Sunday, August 7, 2011

How often to irrigate an Indiana Pouch

How often do you need to irrigate?
            After reading numerous blogs and medical journal articles on this subject I’ve come to the personal conclusion that one irrigation per day (about 200 ml. or five 40-50- ml syringefuls) is worth doing. Here’s why.
            Stone formation within the pouch appears to be more common in persons who irrigate infrequently or not at all. Components of mucus might provide the nucleus for a stone. It takes a year or more, in most people, for the colon to slow down its mucus production. Although I produce less mucus after more than a year than I did in the first couple of months, I’m still surprised occasionally by the large amount that is present. (The next time I go to a Chinese restaurant I’ll avoid the egg-drop soup!)
            Sometimes the largest amount shows up in the third or fourth syringeful. It also helps to vary the position (depth) of the catheter. Unlike your bladder that left the hospital before you did, the new one does not have a smooth interior but has some nooks and crannies – not very scientific terms but descriptive.
            If you make it a practice to irrigate at about the same time every day it will become a habit but not a burdensome one. 
            Guaifenesin might help to reduce mucus. We'll cover it in a later blog.
Check with your surgeon to be sure that he or she agrees with this opinion.

1 comment:

  1. Dr.G,
    This is a wonderful blog. I had a patient recently whose physician wanted him to choose between a neobladder, IP or an ileal conduit. This site helped him. Thank you for doing this.
    Karen RN, CWOCN