Urinary diversion

Kawa Omar, Nawal Shamim Khan, Shahrokh F. Shariat, Johannes Alfred Witjes, Muhammad Shamim Khan

    Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

    Abstract

    Urinary Diversions Urinary diversion involves rerouting of urinary drainage to outside of the body. These procedures can be performed either as a temporising measure or a permanent solution. The most common reason for a permanent urinary diversion is after ablative surgery for malignancy of the urinary bladder or other pelvic organs. However, it can be performed for functional and anatomical abnormalities of the urinary tract. Urinary diversions can be classified as percutaneous, continent, or incontinent. The majority of diversions involve incorporating a segment of bowel in to the urinary tract to either create a conduit or a reservoir. An ideal diversion is one with low pressure, no reflux in to the upper tract, spontaneous and controlled emptying, maintains body image, and is of no functional consequences. However, at present an ideal urinary diversion does not exist. Choice of a urinary diversion depends mainly on the underlying pathology, patient’s compliance and dexterity, renal function, presence of bowel disease, previous bowel surgery, and patient’s preference. All types of diversions have certain advantages and disadvantages. As most types of diversions include change in the body image and lifelong commitment to diversion care, patients need to be appropriately counselled prior to operations as to what the operation might entail. In addition, long-term monitoring of renal function and metabolic and nutritional status are required. In this chapter, we discuss common types of urinary diversion, indications, contraindications, and pros and cons of each.

    Original languageEnglish
    Title of host publicationBlandy’s Urology
    PublisherWILEY-BLACKWELL
    Pages447-464
    Number of pages18
    ISBN (Electronic)9781118863343
    ISBN (Print)9781118863374
    DOIs
    Publication statusPublished - 1 Jan 2019

    Keywords

    • Bricker
    • Continent or incontinent urinary diversions
    • Cystostomy
    • Ileal conduit
    • Mainz II
    • Mitrofanoff
    • Nephrostomy
    • Orthotopic bladder substitution
    • Studer pouch
    • Urinary diversions
    • Wallace

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