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Continent urinary diversion

A continent urinary diversion is an internal pouch made to hold your urine. Your surgeon makes a new opening called a stoma on your tummy (abdomen) for the urine to pass through.

This way of collecting urine allows you to control (be continent) when urine comes out. You don’t have to wear a bag to collect urine, as you would after a urostomy. You pass a thin tube (catheter) into the stoma to pass urine.

It is a more difficult operation than a urostomy and is less commonly used a specialist surgeon has to carry it out. Because the operation is more complicated, about 1 in 5 people need further surgery to correct problems afterwards.

What happens

You have this operation while you’re asleep, so you will have a general anaesthetic. The operation takes between 2 and 6 hours.

You have this surgery at the same time as surgery to remove your bladder (cystectomy). There are 3 parts to the continent urinary diversion operation. These are:

1 .making a pouch to collect your urine
2. making a tube to connect your pouch to the opening on the wall of your abdomen
3. making the opening on the wall of your abdomen (stoma)

The surgeon takes a piece of your bowel and makes it into a pouch inside your body. This is called an internal urine pouch. They attach your ureters to the pouch. These are the tubes which carry urine from your kidneys.

Then the surgeon makes a tube to connect the pouch to your tummy wall. They may use a piece of bowel, your appendix, ureter, urethra, or fallopian tube.

They also cut a small opening on the surface of your tummy (abdomen). This is called a stoma. The part of the bowel where the large and small bowel join is put into this hole. There is a natural valve in this part of the bowel that keeps the stoma closed. Urine does not leak out of the stoma.

Usually, the surgeon makes the stoma under your tummy button (navel) so that it doesn’t show under clothes. You’ll meet the specialist nurse before the operation to talk through best place for your stoma. Once it’s decided they’ll mark the spot on your tummy to guide your surgeon.

Diagram showing a continent urinary diversion

After surgery

When you wake up from surgery you’ll have a lot of tubes attached to your body. Don’t worry this is to help in your recovery. These will gradually come out over time.

You are usually in hospital for about 1 to 2 weeks after this surgery.

You’ll have a thin tube (catheter) that stays in place for about 6 weeks to drain your urine whilst your new pouch, tube and stoma heal. After this time you’ll come back into hospital and the catheter gets removed. The nurse will teach you how to empty your stoma yourself.

Emptying your pouch

You put a catheter into the stoma to drain off the urine. You need to do this at least 4 or 5 times a day. You must be as clean and careful as possible when you do this so that you don't get an infection.

If the pouch gets too full it might leak.

Last reviewed: 
19 Jun 2019
  • Urinary Diversion
    S Daneshmand and others 
    Springer, 2017

  • Good Practice in Health Care. Continent Urinary Diversion
    V Geng and others
    The European Association of Urological Nurses (EAUN), 2010

  • Robotic cross-folded U-configuration intracorporeal ileal neobladder for muscle-invasive bladder cancer: Initial experience and functional outcomes
    T Koie and others
    The International Journal of Medical Robotics and Computer Assisted Surgery, 2018. Volume 0, Issue 0.

  • Mitrofanoff procedure (creation of a catheterisable urinary stoma). Information about the procedure from The British Association of Urological Surgeons (BAUS)
    British Association of Urological Surgeons, 2017

  • Follow the Stream: Imaging of Urinary Diversions
    L N Moomjian and others
    RadioGraphics, 2016. Volume 36. Pages 688 – 709

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. If you need additional references for this information please contact patientinformation@cancer.org.uk with details of the particular risk or cause you are interested in. 

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