Bladder Cancer Treatment: Urinary Diversion - Urology Care Foundation

If you are a patient with bladder cancer, it is important to know your choices for treatment. The type of treatment you receive may differ and as a result, your doctor may need to do a procedure called urinary diversion after the bladder is removed. #BladdersMatter #UrologyCareFoundation #BladderCancer
For more information on urinary diversion and bladder health, visit UrologyHealth.org.
What is Urinary Diversion?
When your bladder is removed or partly removed, you will need another way to store urine and remove it from your body because of cancer or an injury. Urinary diversion is a new way for your body to store and release urine after bladder removal.
Treatment Types
There are two types of urinary diversions: continent and non-continent.
Continent Urinary Diversion
For continent urinary diversion, your surgeon will make a pouch inside your body from part of your intestines to hold urine. With this type of diversion, there are two basic ways urine leaves the body: a catheterizable stoma or an Orthotopic Neobladder, where a surgeon makes an internal pouch much like a bladder to store urine. Ureters are joined to this new “bladder” to empty through the urethra. With a neobladder, you can pee from your urethra.
Non-continent Urinary Diversion
A non-continent urinary diversion, also known as ILEAL CONDUIT, involves linking the long tubes that lead to your bladder, also known as the “ureters”, to a piece of the small intestine that is brought to the skin. This is used to create an opening or stoma on the surface of the belly, usually on the right side of the abdominal wall. The urine leaves the body by the opening and is gathered in a bag for emptying. You will wear the bag under your clothes.
Urinary Diversion Recovery & Side Effects
Most people are happy with their urinary diversions and can develop a new routine.
Urinary diversions problems can happen, though. These may involve:
• changes in fluid and/or salt levels
• trouble placing the tube into the stoma
• problems with skin growing over the stoma
• basic problems that might result from an abdominal operation such as a blocked bowel, or urine or bowel leakage.
If you have a non-continent urinary diversion and need to wear a bag, you will still be able to take part in tough physical activity, as well as your regular daily routines. Most people can wear their normal wardrobe.
It is important you talk to your urologist about the types of urinary diversion to learn which one is best for you. You should talk about all the choices and feel sure in your treatment choice and the lifestyle changes it may bring.

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[@Wunderpus-photogenicus]

Can anyone answer the following question, please? If a patient is diagnosed to be NMIBC (Tis with carcinoma in-situ cancer), and if he decides to not go through the long (very long) invasive treatment (e.g. years of BCG, cystoscopy, TURBT, repeated numerous times), and go directly with radical cystectomy and urinary diversion (e.g. Ileal conduit), is he allowed to do so, and if Medicare or other private insurance will cover that? In other words, will such a patient be "forced" to go through say years of BCG treatment before he can go to the RC and urinary diversion route? Thanks.

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