Urinary diversion is a surgical technique used to create a new pathway for urine to exit the body, often following the removal of the bladder as part of treatment for bladder cancer. In addition to bladder cancer, urinary diversion may be necessary in cases of severe trauma, congenital abnormalities, or other conditions that compromise the normal urinary tract, such as infections or chronic inflammation. The procedure can be either temporary or permanent, depending on the patient’s condition and treatment plan.
There are several types of urinary diversions, each tailored to the patient’s needs. Incontinent diversions involve creating a stoma, an opening on the abdominal wall, where urine is redirected into an external collection bag. Common techniques for this include the use of an ileal or colonic conduit, which repurposes a segment of the intestine to transport urine from the kidneys to the stoma.
In contrast, continent urinary diversions are designed to allow the patient greater control over urine storage and release. These include creating a neobladder, which is constructed from intestinal tissue and allows the patient to void urine through the urethra. When the urethra is not functional, a continent cutaneous reservoir, such as an Indiana pouch, can be formed, enabling the patient to drain urine via a catheter through a small abdominal opening.