The surgical management of the client with bladder cancer involves removal of the bladder and creation of a urinary diversion. Which statement describes an ileal reservoir? A. Urine is diverted directly to the skin surface B. Urine is diverted through a portion of the intestine to the skin surface C. Urine is diverted directly to the large intestine D. Urine is diverted into a surgically created pouch

Before addressing the ileal reservoir concept, let's briefly explain each option: A. Urine is diverted directly to the skin surface: This type of urinary diversion is called a cutaneous ureterostomy. In this procedure, the ureters are brought directly to the surface of the skin, creating a small opening (stoma) for the urine to drain. B. Urine is diverted through a portion of the intestine to the skin surface: This refers to a procedure called an ileal conduit. A small piece of the small intestine (ileum) is used to form a tube-like pathway for the urine to drain from the ureters to a stoma on the skin surface. C. Urine is diverted directly to the large intestine: This procedure is called ureterosigmoidostomy and implies that urine drains into the colon. However, it is not commonly used due to the risk of kidney damage, infections, and other complications. D. Urine is diverted into a surgically created pouch: This refers to the ileal reservoir or neobladder urinary diversion. In this procedure, a portion of the small intestine is used to construct a pouch that stores the urine. The patient can then urinate in a more normal fashion, although it may take practice learning how to empty the reservoir completely.

Based on the given options and their descriptions, the correct statement that describes an ileal reservoir is: D. Urine is diverted into a surgically created pouch (using a part of the small intestine).