Ureteroileostomy

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Ureteroileostomy

Question:

What is a ureteroileostomy?

Answer:

A ureteroileostomy is a surgery to divert urine from your bladder. Advanced bladder cancer that requires complete removal of the bladder is the most likely reason a person would need this type of surgery.

There are many different surgical options. One involves removing a piece of intestine (usually the ileum) and using it as a conduit for urine. One end of intestine is brought out to the skin. The ureter(s) are attached to the other end. Urine then drains from the kidney(s) down the ureter(s) into the intestinal conduit. Urine is collected in a bag that you wear over the intestinal conduit on the skin.

If you do not want to wear a bag and you are an appropriate candidate, the surgeon may create a new urinary reservoir from a longer piece of intestine. The ureter(s) would be attached to the reservoir in a similar manner. The reservoir would be drained 4 to 6 times per day by placing a small tube into the reservoir through a new whole that is created on your abdomen (catherizable stoma). The catherizable stoma is made so that it will hopefully not leak urine.

Another option would be to connect the new urinary reservoir to your native urethra. You may be able to urinate normally, but you may also have to pass a small tube through your urethra (or penis) to empty your bladder. Connecting the reservoir to the urethra may be complicated by urinary incontinence.

Richard Lee, M.D., is a clinical fellow of pediatric urology and a research associate at Children's Hospital Boston. He is a member of the Department of Urology at Children's Hospital Boston.

Last updated:	July 20, 2009