[1] With this type of surgery, a reservoir, or pouch, is created out of approximately two feet of the ascending colon and a portion of the ileum (a part of the small intestine).
This valve normally prevents the passage of bacteria and digested matter from re-entering the small intestine.
Originally, it was thought that removing the ileocecal valve from the digestive tract would likely result in diarrhea, but this has not shown to be the case [according to whom?].
After a period of several weeks, the body adjusts to the absence of this valve (from the digestive tract) by absorbing more liquids and nutrients.
After surgery, patients will have three drainage tubes place while tissues heal: one through the newly created stoma, one through another temporary opening in the abdominal wall into the pouch, and an SP tube (to drain non-specific post-surgical abdominal fluid).
Depending on your doctor's orders, each day, the pouch may need to be irrigated with 60 cc of sterile water in an effort to remove membrane mucus, salts, and bacteria.
The Indiana pouch will require sterile catheters to insert into the stoma to drain the urine every 3–4 hours.
[2] As with the urostomy appliances, the cost of intermittent catheters can be significant, and both are not usually covered fully by most health insurance plans.
The long-term financial costs to the recipient of the Indiana pouch and other urinary diversion techniques are both substantial.
Some patients, after having had an ileal conduit, requiring an external appliance, have opted to have the Indiana pouch, as elective surgery.