What is urinary diversion?

Urinary diversion is a surgical procedure the creates a new way for urineto departure your body as soon as urine circulation is clogged or when there is a need to bypass a diseased area in the urinary tract.

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The urinary street is her body’s drainage device for remove urine, which is make of wastes and extra fluid. Your urinary tract is design to have the urine circulation from the kidneys, v the ureters, come the bladder, and out the urethra. Once the pee can’t flow normally, it may build up in your bladder, ureters, or kidneys. This buildup of urine may reason pain, urinary tract infections, urinary stones or calculi, damage to your urinary tract, or kidney failure. If left untreated, a buildup of to pee in the urinary tract can be life-threatening.

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All components of the urinary tract—the kidneys, ureters, bladder, and urethra—must job-related together come urinate normally.

Urinary diversion may be temporary—the flow of pee is rerouted for numerous days, weeks, or periodically months till the urine can flow normally again—or permanent—surgery is done to produce a permanent readjust to the means urine flows v the body.

Why might I need a urinary diversion?

The most typical reason you could need a urinary diversion is bladder cancer that needs the bladder to be removed—a procedure referred to as a cystectomy.

Other factors for a urinary diversion include

conditions that cause outside push to the urethra or one or both ureters urinary stones

What room the species of urinary diversions?

The main species of urinary diversion include

cystostomy

Bladder catheterization

Bladder catheterization entails inserting a thin, versatile tube—called a catheter—into the bladder to drainpipe urine. The pee drains right into a arsenal bag external the body. The two varieties of urinary catheters include

Foley catheter, inserted into the bladder through the urethra suprapubic catheter, placed into the bladder v a little hole in the skin beneath the ship button

Urinary catheters may remain in place for number of days or weeks while tissues heal after urinary tract surgery or treatment of urinary blockage and, in some cases, may be permanent. Catheters that are in location for much longer periods that time need to be changed with a new catheter periodically.

Cystostomy

A cystostomy is a operation procedure where a medical professional inserts a little tube into your bladder v the skin that the lower abdomen. The tube allows urine to drainpipe from your bladder into a bag outside your body.

Nephrostomy

Similar come a cystostomy, during a nephrostomy a operated doctor or radiologist provides a tiny incision and also inserts a tiny tube, called a nephrostomy tube, v the skin that your back into her kidney. The nephrostomy tube permits urine to drain from your kidney right into a bag outside your body.

You might need a nephrostomy as soon as being treated because that a kidney stone or as soon as your ureters space narrowed, blocked, or inflamed. Relying on the reason for the nephrostomy and also how quickly your body heals, the nephrostomy tube might be used for different lengths of time.

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Nephrostomy tube and also external drainage pouch

Ureteral stent

A ureteral stent is a thin versatile tube the is put into the ureter to assist urine flow from the kidney to the bladder. The ureteral stent is guided with a cystoscope into your ureter, then one end of the stent is placed in the kidney and the other finish is placed in the bladder.

You might need a ureteral stent if one of your ureters is blocked as a an outcome of surgery, a kidney stone, a tumor, or infection. A ureteral stent is usually short-lived but, in part cases, deserve to be offered to permanently manage a blockage the the ureter. Ureteral stents that are in location for longer periods the time must be replaced periodically.

Urostomy

A urostomy is a stoma, or opening, in her abdomen that connects to your urinary street to allow urine to drain freely from her body. Pee is gathered and save on computer in a small bag, referred to as a urostomy pouch, i m sorry you have the right to empty at her convenience. The bag is attached come the skin roughly your stoma and worn exterior your body.

The 2 main species of urostomy include

Ileal conduit. A surgeon gets rid of a piece of her intestine to create a passageway for urine. The ureters space attached come the piece of intestine, then the intestine is attached come an opening in your abdomen, developing a stoma. The urine flows from the ureters, through the item of intestine, and also out the stoma. Cutaneous ureterostomy. A operated doctor attaches one or both ureters straight to a stoma in her abdomen.
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Ileal conduit and also stoma
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Cutaneous ureterostomy
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Continent cutaneous reservoir
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Bladder substitute

The kind of urinary diversion procedure you have actually depends on various factors, including your age, prior clinical history, previous surgeries, exactly how well you deserve to move around, if you’ve had radiation treatment or cancer, your capability to usage a catheter, and also your preference.

What must I intend after urinary diversion surgery?

A nurse will teach you how to manage and also care for her urinary diversion. Talk v your health care professional about any questions or concerns you have actually caring because that or living with your stoma, urostomy pouch, continent cutaneous reservoir, or bladder substitute.

Always wash her hands through soap and also water before and also after caring for your urinary diversion come avoid presenting bacteria or other foreign substances that could lead to infection.

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Wash your hands thoroughly with soap and water before and after caring for your urinary diversion.

Caring because that a stoma

Care for your stoma every day to store the stoma and also skin approximately the stoma clean and healthy.

wash the stoma and surrounding skin with warmth water. If utilizing soap, pick mild soap only. Wash the stoma and also surrounding skin thoroughly. Avoid commodities that save oils, fragrance, deodorants, alcohol, or harsh chemicals. Tenderness pat the stoma and also surrounding skin dried completely. Check the stoma and also surrounding skin and contact your health care professional if you an alert any skin changes or irritation.

Living with a urostomy pouch, continent cutaneous reservoir, or bladder substitute

Urostomy pouch. If you have actually an ileal conduit or cutaneous ureterostomy, you require to treatment for her urostomy pouch, also called a pouching system. Girlfriend either have actually a two-piece pouching system with a barrier that sticks come the skin and a pouch that attaches to the barrier, or a one-piece system with a skin barrier and also pouch an unified as a solitary unit. The skin barrier, additionally called a wafer, fits over your stoma and also is designed to defend your skin. You empty the pee by opening a valve ~ above the pouch and also drain the urine into a toilet.

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Urostomy pouch

Your pouching device is designed to stop urine leaks, safeguard your skin indigenous urine, keep the skin roughly your stoma healthy, and also avoid odor. Actions to treatment for your pouch include

emptying the bag often—empty the pouch when it is one-third to one-half full to avoid leaks, skin irritation, and also odor an altering the bag regularly—most pouches have to be changed 1 come 2 times per week, but how frequently you require to readjust your pouch depends on the type of pouch you wear, exactly how well the skin obstacle fits, the problem of the skin about your stoma, your task level, her body shape, and also your level of perspiration maintaining the skin approximately the stoma clean—each time you change the pouch, gently clean the skin about the stoma and dry the skin fully before putting on a brand-new pouch

At night, you can connect a item of flexible tubing come the drain valve on your pouch to permit urine to flow into a night drainage unit while friend sleep.

Talk v your health treatment professionals around the best way to treatment for your pouching system. Castle may indicate ostomy assets such together ostomy powder or skin sealant to prevent skin wake up or to help the pouching system stick to her skin better.

You execute not need special clothes with a urostomy pouch. Pouches are easily accessible in countless different varieties to fit your body, so they aren’t noticeable under clothing. You might want come tuck her pouch inside her underwear or undergarments, wear snug underwear, or wear a belt the attaches come the pouch for extra support and also security.

Continent cutaneous reservoir. Talk with your health treatment professional about how to care for her continent cutaneous reservoir, including how frequently to drain and irrigate the internal pouch or bladder. In general, you will

empty the inner pouch or bladder by inserting a catheter with the stoma to drainpipe the urine—every 2 hours for the first couple of weeks ~ urinary diversion surgery, and also every 4 to 6 hrs as the pouch stretches and can hold more urine or as your bladder heals save the skin around the stoma clean—before and after you use a catheter, tenderness clean the skin about the stoma and dry the skin completely irrigate, or do the washing up out, the internal pouch utilizing a syringe and also sterile water or regular saline to remove mucus the can develop up within the pouch

If you have actually trouble inserting the catheter into your stoma, call your health care professional ideal away.

Bladder substitute, or neobladder. Talk through your health care professional around how to care for your bladder substitute. It is crucial that you take steps to make certain the bladder substitute does not gain overstretched, including

empty her bladder instead of often—every 2 come 3 hours during the day and also every 3 come 4 hrs at night for the first couple of weeks after ~ urinary diversion surgery, gradually lengthening to every 4 come 6 hours during the day and at the very least once in ~ night usage a catheter come empty her bladder instead of if it no emptying completely

Mucus may build up in the bladder substitute, which can lead come infection. You may need to use a catheter come irrigate, or do the washing up out, the rubber periodically.

You may leak urine, particularly in the very first 6 come 12 month after bladder substitute surgery. You have the right to use disposable pads or briefs come absorb leaking urine. To pee leakage is especially common at night and, in some cases, continues past the first year after surgery.

Infection

Bacteria can go into urostomies and also continent urinary diversions and may cause a urinary tract infection. Symptom of epidemic include

fever chills poor appetite ago or lower side pain frequent, ache urination cloudy, dark, or strong-smelling urine

If you have symptoms of one infection, watch a health treatment professional ideal away.

Drink eight 8-ounce glasses of liquids every day—or much more if encourage by her health treatment professional—to assist prevent infection. Talk through your health care professional about urine testing and when to treat an infection.

Activities

Most civilization can return to their usual activities and exercises, consisting of swimming and other water sports, once they have healed from urinary diversion surgery and regained your strength. You need to avoid particular vigorous tasks and heavy lifting ~ your surgical treatment while your body heals.

Talk through your health care professional if your job is strenuous or requires heavy lifting, or if friend play contact sports. Your health treatment professional may indicate that you readjust your task responsibilities, wear security padding, or avoid specific activities that might harm your stoma.

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Most civilization with a urinary diversion can return to the same tasks they enjoyed before the surgery.

Relationships

You might worry around how other civilization view your urinary diversion. Most world won’t know you’re attract a pouch or have actually a urinary diversion unless you phone call them. Friend can select who to speak to and also how much info to share.

Urinary diversion surgery might reduce sex-related function; however, many civilization with a urinary diversion have actually satisfying sex-related relationships. Your health care professional may suggest certain treatments, medicines, or therapy to aid improve your sexual function. Talk with your health care professional about when that is safe for you come resume sex-related activity, any type of pain friend are having with sex, methods to safeguard the stoma, questions about intimacy, and any pertains to you have around maintaining a healthy and balanced sexual relationship. That is likewise important to communicate openly with your partner around intimacy concerns.

Living with a urinary diversion needs some adjustment, and some world may feeling discouraged or depression after surgery. Friend may uncover it useful to talk through a friend, family member, therapist, or support group about how you space feeling.

Will mine diet need to readjust after urinary diversion?

Most civilization return to a normal dietafter a urinary diversion. You might want come avoid particular foods the can reason urine to have actually a solid smell, such as asparagus and seafood, which may be noticeable when you empty the pouch. Civilization with certain varieties of urinary diversion might not have enough vitamin B12 in their bodies and may need vitamin B injections. Talk through your health treatment professional about your dietary needs.

Clinical Trials for Urinary Diversion

The ptcouncil.net conducts and supports clinical trials in plenty of diseases and also conditions, including urologic diseases. The trials look come find brand-new ways to prevent, detect, or treat condition and improve quality the life.

What space clinical trials because that urinary diversion?

Clinical trials—and other varieties of clinical studies—are component of clinical research and involve people like you. Once you volunteer come take part in a clinical study, you help health treatment professionals and also researchers learn more about disease and improve health treatment for civilization in the future.

Researchers space studying many aspects of urinary diversion, such as

reducing complications after surgery boosting postoperative care and reducing length of hospital continue to be surgical outcomes the robot-assisted surgery

Find out if clinical studies are right for you.

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What clinical researches for urinary diversion are trying to find participants?

You deserve to view a filtered list of clinical research studies on urinary diversion that are open and also recruiting in ~ www.ClinicalTrials.gov. You can broaden or small the list to include clinical researches from industry, universities, and also individuals; however, the ptcouncil.net walk not evaluation these studies and also cannot ensure they are safe. Always talk with your health treatment professional prior to you get involved in a clinical study.


This content is provided as a company of the national Institute that Diabetes and Digestive and Kidney Diseases(ptcouncil.net), component of the national Institutes the Health. The ptcouncil.net translates and disseminates study findings to rise knowledge and understanding about health and disease among patients, health professionals, and the public. Content created by the ptcouncil.net is carefully reviewed through ptcouncil.net scientists and other experts.

The ptcouncil.net would like to thank:Badrinath Konety, M.D., M.B.A., rush University clinical College