Brief review of urinary diversion, loopogram, Loopogram Procedure, Benefits and associated risks, Bladder cancer, Abnormal loopogram findings

1. By: Suman Shaikh
COP, JPMC
PRESENTATION ON
LOOPOGRAM

2. Urinary Diversion
Loopogram
Loopogram Procedure
Benefits and associated risks
Bladder cancer
Abnormal loopogram findings
Topic outline:

3. Urinary diversion
Urinary Diversion is a surgical procedure which is done to
reroute urine flow from its normal pathway.
1. It is indicated when the bladder
can no longer safely function as
a reservoir for urine storage.
2. It is created after the removal of
the urinary bladder (radical
cystectomy or
cystoprostatectomy, usually
done to treat invasive bladder
cancer).
Stoma

4. Loopogram
 This is a test to show the loop of bowel (conduit) that
has been used as a substitute for your urinary
bladder.

8. Loopogram Procedure
 Fluoroscopic imaging is done with a contrast called X-
ray Dye.
 The contrast dye shows up on the images and allows
the radiologist to clearly see and check the internal
organs.
1. Patients lies supine on the examination table.
2. The stoma bag will be removed
3. The radiologist will clean the urostomy stoma and
insert a catheter
4. Contrast (x-ray dye) will be injected through the
catheter and several images will be taken.
5. This exam usually takes about 30 minutes to 1 hour.

9. What does a Loopogram
Examination show?
 The examination shows:
1. Kidneys
2. Ureters
3. Ileum (the loop of bowel that the ureters are now attached to)
4. Stoma (the opening on the outside of your abdomen)
 It is done to ensure that the conduit and surrounding organs are
functioning efficiently.
 This procedure is also known as Ileal Conduitogram and Ileal
Loopography.

10. Benefits
 This examination will help your doctor to make a
correct diagnosis or decision about your treatment.
 It is an X-ray procedure, so there are some risks
associated with radiation. But the radiation should be
kept as minimum as possible.
Associated Risks

11. Role of Loopogram in
Bladder Cancer
1. Surgery for bladder cancer
involves a laparoscopic radical
cystectomy.
2. In this procedure, the bladder is
removed.
3. To restore urinary flow, surgeons
then have a number of options to
divert the flow of urine.
4. For this, they reposition a section
of bowel from small intestine and
connect the ureters to it which
helps urine to flow through
stoma.
5. A loopogram tests the ileal
conduit (or replacement
bladder) to see if it is
functioning as it should.

12. Abnormal Findings on the
Loopogram

13. Abnormal Findings on the
Loopogram