Urinary diversion/continent urinary diversion (Indiana pouch)

Urinary/continent urinary diversion (Indiana pouch)

Bladder removal or the bypassing of the normal urinary route with an opening made in the urinary system to divert urine through an opening in the abdominal wall.
Reasons for urinary diversion

  • Accident or disease of the bladder
  • Non-functioning bladder

Types of urinary diversion

Continent urinary diversion - no permanent ostomy bag required

Type 1: Replacement bladder (Indiana pouch) made from intestine. Patient may urinate spontaneously.

Concerns that are normal:

  • Blood on the stoma pad
  • Heavy mucus
  • Leaking
  • Retention of urine-failure to completely empty the pouch
  • Small amounts of blood in the urine
  • Swelling of the stoma and the channel into the pouch

Concerns that should be addressed at once:

  • Chills/fever
  • Gross blood in the urine
  • Nausea/vomiting
  • Persistent abdominal or kidney pain
  • Thick, cloudy, foul-smelling urine

Type 2: Surgical opening through the abdominal wall. Patient must drain accumulated urine by periodically self-catheterization.

Urostomy

Non-continent urinary diversion - permanent ostomy bag required

Although there are four types of urostomies, most urinary diversions are the ileal conduit type, whereby the ureters are connected to the intestine, and the intestine is brought to the surface of the abdomen. Urine drains into an ostomy bag.

Concerns that are normal:

  • Heavy mucus
  • Leaking

Concerns that should be addressed at once:

  • Chills/fever
  • Gross blood in the urine
  • Nausea/vomiting
  • Persistent abdominal or kidney pain
  • Thick, cloudy, foul-smelling urine

Irrigating/Flushing Your Stoma

  • This should be done as often sas your physician tells you to keep your new bladder draining.

Post-procedure instructions

  • Drink plenty of fluids. Dark urine indicates a need to increase fluid intake.
  • The skin around the stoma should be protected with a durable skin barrier.