Urinary diversion

Any surgical procedure (temporary or permanent) that allows urine flow when the outlet channel of the urinary tract, via the bladder and urethra, is obstructed or cannot be used, or the bladder has been surgically removed. Temporary urinary diversion is sometimes needed when urine passage is blocked by prostate gland enlargement or by urethral stricture. A tube is passed directly into the bladder through a small opening in the abdomen (see catheterization, urinary). Temporary diversion is also required after some urinary tract operations; a small tube is introduced into the kidney and brought to the abdominal surface. Permanent diversion is needed when the bladder has been surgically removed, when neurological bladder control is severely disturbed, such as after severe spinal injury, or if there is an irreparable fistula between a female patient’s bladder or urethra and her vagina. A section of the ileum is removed to create a substitute bladder, into one end of which the surgeon implants the ureters. The other end of the substitute bladder is then brought out through an incision in the abdominal wall. The patient wears a bag attached to the skin to collect urine.