Why is this procedure done?
The urinary tract is made up of the kidneys, ureters, bladder, and urethra. When the kidney makes urine, it drains down into tubes called ureters. The ureters connect to the bladder, which stores urine. When the bladder is full, it squeezes the urine out into the urethra and out of the body. ‚
There are some conditions that can block this pathway. When this happens, doctors may need to make another way for urine to come out. One procedure that makes this other pathway is called continent urinary diversion. With this procedure, your doctor uses a small part of your bowel to make a reservoir, or pouch, to hold the urine. You are able to drain the urine when you want. ‚
What will the results be?
Your body will have a different way for urine to drain. You will not have to wear a bag, pouch, or catheter all of the time. ‚
What happens before the procedure?
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- Lab tests
- X-rays
- MRI or CT scan
- Ultrasound
- Cystoscopy to look into the bladder
- Antibiotics to lower the chance of infection during the surgery
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, the staff will put an IV in your arm to give you fluids and drugs. You will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. You may be asleep or awake during the procedure.
- Your doctor may do 1 of 2 types of continent urinary diversions.
- Cutaneous continent urinary diversion
- The doctor will clean the part just below your belly button with an antiseptic. The doctor will make a cut through the lower belly. The doctor uses a small part of your bowel to make a new reservoir for your urine. The ureters are connected to the reservoir and it is brought up to the skin with an opening called a stoma.
- The doctor will close the cut, leaving a space for the stoma. The doctor will cover the wound and stoma site with a clean dressing.
- Orthotopic continent urinary diversion
- The doctor will clean the part just below your belly button with an antiseptic. The doctor will make a cut through the lower belly. The doctor uses a small part of your bowel to make a new reservoir for your urine. The doctor connects the ureters to the reservoir. Then the reservoir is connected to your urethra so the urine will leave your body the normal way.
- The doctor will close the cut and cover the wound with a clean dressing.
- The doctor may place a drain tube in your lower belly from your bladder and a drain tube from the bladder through the urethra until the bladder heals.
- Your doctor may collect urine from the tube to be sent to the lab for testing.
- The procedure takes 2 to 3 hours.
What happens after the procedure?
- You will go to the Recovery Room and the staff will watch you closely. You may have to stay in the hospital for 1 to 3 days.
- You may have discomfort and numbness after the procedure. Your doctor will give you drugs for this.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Your doctor will give you drugs for pain and to prevent infection. Take them as ordered by your doctor.
- Wash your hands before and after touching the cut site and before and after draining urine.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds (4.5 kg)
- When you may go back to your normal activities like work, driving, or sex
- How to care for drain tubes at home
- How to exercise your bladder to pass urine
- Learning self-catheterization to drain urine from the bladder
- Caring for the stoma if one is made during the procedure, and using a drain bag to collect urine
What follow-up care is needed?
- Your condition needs close monitoring. Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
- Drain tubes most often are in place for 2 to 3 weeks after the procedure.
- The doctor may have you work with a physical therapist or nurse to learn to drain urine from the bladder pouch.
What lifestyle changes are needed?
- You may have to limit your activity. Talk to your doctor about the right amount of activity for you.
- You may need to carry extra clothing and bladder protection pads with you right after surgery in case of urine leakage.
- Use a waterproof mattress cover to prevent damage from leaking urine at night.
- Drink fluids regularly unless your doctor tells you not to do so to prevent urinary tract infection.
What problems could happen?
- Infection
- Bleeding
- Catheter gets blocked or kinked
- Leaking of urine, especially at night
- Kidney problems
Where can I learn more?
American Urological Foundation ‚
http://www.urologyhealth.org/urology/index.cfm?article=106 ‚
Kidney and Urology Foundation of America ‚
http://www.kidneyurology.org/Library/Urologic_Health.php/Urostomy_and_Continent_Urinary_Diversion.php ‚
National Kidney and Urologic Diseases Information Clearinghouse ‚
http://kidney.niddk.nih.gov/kudiseases/pubs/urostomy/ ‚
Last Reviewed Date
2015-01-16 ‚
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Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider 's advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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