What is Urinary Diversion?
You don't need to have a bladder to live, but you do need to keep up a normal flow of urine from the body. If for some reason there is a problem with your urinary system, there are ways to change your "plumbing."
What Happens under Normal Conditions?
The urinary tract is like a plumbing system, with special ‘pipes' that allow water and salts to flow through them. The urinary tract is made up of 2 kidneys, 2 ureters, the bladder, and the urethra.
The kidneys act as a filter for the blood. They remove toxins and keep the useful sugar, salts, and minerals. Urine, the waste product, is made in the kidneys and flows down 2, 10 to 12-inch-long tubes called ureters into the bladder. The ureters are about a quarter inch wide and have muscled walls which push the urine into the bladder. The bladder can swell to store the urine until you are ready to drain it by peeing. It also closes the pathways into the ureters so urine can't flow back into the kidneys. The tube that carries the urine from the bladder out of the body is called the urethra.
What is Urinary Diversion?
Urinary diversion is when the normal structures are bypassed and an opening is made in the urinary system to bring the urine out another way. This might need to be done if your bladder stops working the right way or needs to be removed because of cancer or an injury. The flow of urine is diverted to a replacement bladder ("neobladder") or through an opening in the abdominal wall (called a "stoma").
Treatment
There are 2 types of urinary diversions: continent and non-continent.
Non-continent Urinary Diversion
Non-continent urinary diversions often involve linking the ureters to a piece of intestine that is brought out of the belly. The urine then drains continuously into an ostomy bag you wear under your clothes. You'll still be able to take part in strenuous physical activity, as well as daily routines.
Continent Urinary Diversion
For continent urinary diversion, your surgeon will make a pouch inside your body from part of your intestines to hold urine. There are 2 basic types: those that have a stoma brought out of the belly and those in which a neobladder is made. With a neobladder, you are able to pee in a normal way.
With a surgical stoma, you will need to insert a tube into the stoma to drain the urine 4 or 5 times a day.
The advantage of both types of continent urinary diversion is that you don't need to wear an ostomy bag.
After Treatment
Most people are satisfied with their urinary diversions and are able to return to a normal routine.
Problems with urinary diversions do happen, though, such as:
- changes in fluid and/or salt levels
- trouble inserting the tube into the stoma
- problems with skin growing over the stoma
- basic problems that might result from an abdominal operation (such as a blocked bowel, or urine or bowel leakage)
Frequently Asked Questions
Can I wear normal clothing if I have an ostomy bag?
Most people are able to wear their normal wardrobe.
Will I be on a special diet?
Not usually. Your health care provider will give you orders about fluids and nutrition if needed as you adjust.
Source: Urology Care Foundation.