AUA Summit - What is Urinary Diversion?

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Urinary Diversion

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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 let water and salts to flow through them. The urinary tract is made up of two kidneys, two 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 the 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 stores the urine until you are ready to empty it by peeing. 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 pathway for urine leaving the body is changed. This might need to be done if your bladder stops working correctly or it 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").

Diagram of the Male and Female Urinary Tracts

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Treatment

There are two 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 will still be able to take part in strenuous physical activity, as well as daily routines.

Diagram of Urostomy

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Continent Urinary Diversion

For continent urinary diversion, your surgeon will create a “pouch” inside your body from part of your intestines to hold urine. There are two 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 (catheter) into the stoma to drain the urine four to five times per day.

Diagram of Self Catheterization of a Urinary Diversion

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The advantage of both types of continent urinary diversion is that you don't need to wear an ostomy bag.

Diagram of Continent Urinary Diversion

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After Treatment

Most people are satisfied with their urinary diversions and can go back to a normal routine.

Problems with urinary diversions may happen, 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 clothing.

Will I be on a special diet?

Not usually. Your health care provider will give you recommendations about fluids and nutrition if needed as you adjust.

Updated October 2024. 

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