Continent urinary diversion
Continent urinary diversion is not commonly used today after surgery to remove the bladder, but it may be an option in some circumstances.
In this procedure, the surgeon uses a piece of the small bowel to create a pouch inside the body. A valve allows urine to be stored inside the pouch and then removed through a stoma (an opening on the surface of the abdomen).
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The surgeon connects the pouch to the ureters, which drain urine into it from the kidneys. The pouch valve is joined to the surface of the abdomen, where the stoma is created.
Several times a day, you will need to drain the urine by inserting a drainage tube (catheter) through the stoma into the pouch. Once the pouch is empty, you remove the catheter. You do not have to wear a bag over the stoma.
Continent urinary diversion
Continent urinary diversion became popular for a time because it doesn’t require a stoma bag, but there is a high risk of problems requiring further surgery.
Using the catheter requires good hand–eye coordination, so continent urinary diversion may not be an option if you are elderly or if your coordination is limited for another reason.
See a stomal therapy nurse or urology nurse – They can teach you how to use the catheter to drain your pouch and will help you set up a schedule so that you are emptying it regularly. You will probably need to empty it about five times a day. It may take a while to become comfortable using the catheter, but most people find that they can return to their usual activities over time.
Keep the stoma and surrounding skin clean – Regularly wash your stoma with mild soap and water, and wipe away any extra mucus. Rinse the stoma well and dry it thoroughly.
Look for signs of blockages – The opening to the pouch may become blocked by urinary tract stones, a mucus plug or another obstruction. This will cause pain. It can usually be relieved using the catheter to drain the urine through the stoma. If this doesn’t work, seek urgent medical attention. In rare cases, a swollen abdomen and/or abdominal pain can mean that the pouch created to store urine has ruptured. This is a medical emergency, so you should go straight to hospital.
Download a PDF booklet on this topic.
Prof Dickon Hayne, UWA Medical School, The University of Western Australia, and Head, Urology, South Metropolitan Health Service, WA; BEAT Bladder Cancer Australia; Dr Anne Capp, Senior Staff Specialist, Radiation Oncology, Calvary Mater Newcastle, NSW; Marc Diocera, Genitourinary Nurse Consultant, Peter MacCallum Cancer Centre, VIC; Dr Peter Heathcote, Senior Urologist, Princess Alexandra Hospital, and Adjunct Professor, Australian Prostate Cancer Research Centre, QLD; Melissa Le Mesurier, Consumer; Dr James Lynam, Medical Oncologist Staff Specialist, Calvary Mater Newcastle and The University of Newcastle, NSW; John McDonald, Consumer; Michael Twycross, Consumer; Rosemary Watson, 13 11 20 Consultant, Cancer Council Victoria.
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