✦ Urinary Diversion Treatment

Indiana Pouch (Continent Cutaneous)

Q: How often do I need to catheterise an Indiana Pouch?

Catheterisation every 4–6 hours during waking hours; most patients catheterise 4–6 times per day, including once at night. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Q: Can the Indiana Pouch be done after pelvic radiation?

Yes — the Indiana Pouch uses right colon which often receives less radiation than the pelvis; it is one of the preferred diversions in irradiated patients.

Q: What are the long-term complications of Indiana Pouch?

Stomal stenosis, reservoir stones, and urinary tract infections are the main long-term issues; most are manageable with minor interventions.

Continent Cutaneous Urinary Reservoir with Self-Catheterisation Stoma

4–6 Hours PROCEDURE

8–14 Days HOSPITAL STAY

>90% SUCCESS RATE

6–8 Weeks RECOVERY

What is Indiana Pouch (Continent Cutaneous)?

The Indiana Pouch is a continent cutaneous urinary diversion constructed from the right colon and terminal ileum, with a tapered ileal efferent limb brought to the skin as a flush, continent stoma. Patients self-catheterise through the flush stoma 4–6 times daily. Unlike the ileal conduit, no bag is required between catheterisations. The Indiana Pouch provides a high-capacity, low-pressure reservoir suitable for patients who cannot have an orthotopic neobladder due to urethral involvement or prior radiotherapy. The procedure is performed under general or spinal anaesthesia with a hospital stay of 8–14 Days.

Patients requiring urinary diversion who cannot receive orthotopic neobladder (urethral involvement, prior pelvic radiation) and prefer to avoid a urostomy bag. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Bowel Segment Isolation

Right colon and 10–15 cm terminal ileum isolated; bowel continuity restored.

Reservoir Construction

Colon detubularised and folded to create a large-capacity spherical low-pressure reservoir.

Ureteric Anastomosis

Ureters reimplanted into the colon reservoir with tunnelled anti-reflux anastomoses.

Efferent Limb Creation

Terminal ileum tapered and imbricated to create the continent efferent limb.

Stoma Maturation

Efferent limb brought to skin; flush stoma matured; catheter left for 4–6 weeks during healing.

Outcomes

4–6 HoursDURATION

8–14 DaysHOSPITAL STAY

>90%SUCCESS RATE

6–8 WeeksFULL RECOVERY

Who Needs This Treatment?

→No external bag required — continent self-catheterisable stoma.
→High-capacity low-pressure reservoir suitable for all ages.
→Alternative continent diversion when neobladder is not possible.
→Flush stoma at umbilicus or right iliac fossa is barely visible under clothing.
→Over 90% continence between catheterisations with correct technique.
→Large reservoir capacity allows 4–6 hour catheterisation intervals.

"The Indiana Pouch offers patients the freedom of continent diversion when a neobladder is not feasible. With good patient selection and meticulous construction, over 90% achieve reliable continence and an excellent quality of life."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

How often do I need to catheterise an Indiana Pouch?+

Can the Indiana Pouch be done after pelvic radiation?+

What are the long-term complications of Indiana Pouch?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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