Continent urinary diversion
What is content urinary diversion?
A continent urinary diversion is a new way for you to pass urine (pee) if your bladder has been removed. You use a tube called a catheter to drain urine through an opening called a stoma on your tummy (abdomen).
Surgery to remove the bladder is called a cystectomy. You may have this as part of your treatment for bladder cancer.
There are different types of urinary diversion and different types of stomas. We have more information about the following types:
- Bladder reconstruction (neobladder) – this is an operation to make a new bladder from a section of your bowel.
- Urostomy – this is an opening on your tummy that lets urine drain out of the body into a bag.
- Nephrostomy – this is an opening on the back of the body that lets urine drain from the kidney.
- Colostomy and illeostomy – this is an opening connecting the bowel to the tummy.
How a continent urinary diversion is made
The surgeon makes the continent urinary diversion during the operation to remove the bladder. They make a pouch that holds urine (pee) from a section of the bowel. They attach the 2 tubes from your kidneys called ureters to the pouch so that urine from the kidneys drains into the pouch.
The surgeon uses another part of the bowel such as the appendix to make a tube to connect the pouch to the tummy wall. They make a small opening called a stoma from the tube on to the tummy wall. This type of stoma lies flat against the skin.
After surgery
After surgery, you will have 2 catheters in place. One goes into the pouch through your tummy and the other goes through the stoma. These stay in place for a few weeks while you recover from the operation.
Once the pouch has healed you will go back to the hospital. It usually takes about 6 weeks after surgery for the pouch to heal.
You will usually stay in hospital for 1 or 2 days for the catheters to be removed. You will also learn how to empty the pouch and wash it out. Your specialist nurse will teach you how to do this.
Before you leave the hospital, the nurse will make sure you have a supply of the things you need. This will include catheters. When you are at home, you can get your equipment free on prescription directly from a supplier or your chemist. Your nurse will tell you more about this. The Urostomy Association can also give you details of suppliers.
When you get home, you will still be able to speak to your specialist nurse for advice. The hospital staff will arrange for a district nurse or a community stoma nurse to visit you when you first leave the hospital. They can help you cope with any problems.
Emptying your pouch
To empty your pouch, you put a tube called a catheter through the stoma into the pouch. Your specialist nurse will show you how to do this. At first, you do it every 1 to 2 hours, until your pouch stretches.
Eventually, you may be able to leave the pouch for up to 6 hours without emptying it. You may find it helpful to set an alarm to remind yourself to empty the pouch.
Washing out your pouch
As well as emptying your pouch, you need to wash it out. The bowel tissue used to make the pouch continues to make mucus. This is a thick, white liquid. It might appear as pale threads in the urine (pee). If it is not washed out, it can cause an infection.
You need to wash out your pouch several times a day. To do this, you put fluid through the catheter that you use to drain your pouch. Your specialist nurse will teach you how to do this.
Different surgeons may give slightly different instructions on how you should empty and flush out your pouch, and the equipment you should use. Follow the advice you are given. If you need more support, talk to your specialist nurse or doctor.
Living with a continent urinary diversion
Getting used to a urinary diversion and learning to look after it takes time. Like anything new, it will get easier with time and practice.
Your specialist nurse will give you lots of support before and after your operation. They will show you how to care for and manage the urinary diversion.
If you feel anxious about your body or about going out in public, it may help to talk to others in a similar situation. Our Online Community has a stoma support forum where you can share your experience and find out how other people have coped. You can also call the Macmillan Support Line for free on 0808 808 00 00.
You may also want to find out more about coping with body changes and body image after cancer. Or read our tips for using public toilets when you are not at home.
About our information
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References
Below is a sample of the sources used in our bladder cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
Mottet N, Bellmunt J, Briers E, et al. Non-muscle-invasive bladder cancer (TaT1 and CIS). European Association of Urology (Internet), 2021. Available from uroweb.org/guideline/non-muscle-invasive-bladder-cancer (accessed September 2021).
Witjes JA, Bruins HM, Cathomas R, et al. Muscle-invasive and metastatic bladder cancer. European Association of Urology (Internet), 2021, Available from uroweb.org/guideline/bladder-cancer-muscle-invasive-and-metastatic (accessed September 2021).
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Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Ursula McGovern, Consultant Medical Oncologist.
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Date reviewed
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