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April 3rd, 2012

Daniela’s Story – Bladder Surgery

By uclahealth

Innovative bladder surgery helps to give Daniela greater freedom and independence

Daniela Schirmer was home from college and having lunch in a restaurant with a friend when she slipped in the restroom and struck her head on the wall. The force of the impact broke the 22-year-old student's neck. As a result of the accident, Daniela was left a quadriplegic, unable to use her legs and with limited use of her arms and hands.

Daniela has spent the past three years fighting against her injury to regain independence. One of the major obstacles she faced was lack of bladder control and her inability to manage a normally placed catheter.

"Bladder management was the one thing that was really getting in the way of my said independence," Daniela says. "I had to catheterize five times a day … but somebody else had to do it for me. And it was just a complete invasion of privacy, and I had to time my days around when I had to go to the bathroom."

To address Daniela's problem, UCLA urologist Ja-Hong Kim, M.D., performed surgery to essentially reconstruct the young woman's bladder. Using a piece of Daniela's intestines, Dr. Kim constructed a patch of living fabric to expand the bladder, giving it more capacity. She then re-purposed Daniela's pipe-shaped appendix to route the urine to the outside, in a location she could reach to catheterize.

And she did something extra. "Rather than connecting the bladder and the appendix to the skin where it would be noticeable, we decided to connect it to her belly button, and hide it," Dr. Kim says.

Daniela SchirmerSince the surgery, Daniela can now imagine such things as returning to school, having a job, dating again, "and just have as fulfilling and normal a life as possible."

"We're quite pleased with how everything worked out," Dr. Kim says.

Says Daniela: "My greatest hope is to maintain my adventurous spirit. I don't want to be limited by my spinal-cord injury. I'm okay with dealing with it now. It's a difficult part of my life, but I don't want that to stop me."

Tags: Dr. Ja-Hong Kim, patient stories, urology, Urology

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