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 What is a urinary reconstruction and diversion?

The diagnosis of bladder cancer or other serious bladder disease may sometimes necessitate the surgical removal of the bladder.  In this situation, it is necessary to create a new way for the patient’s body to pass urine. This type of surgery is known as urinary diversion surgery.  There are several options available for patients requiring urinary diversion.

At City of Hope, in addition to the standard open surgical approach to removal of the bladder and urinary tract reconstruction, we also perform this operation using a robotic-assisted laparoscopic approach.  A patient’s options for urinary diversion remain the same, regardless of the surgical approach.

The Anatomy
The normal urinary tract is made up of two kidneys, which filter the blood and remove extra water and waste through the urine. Urine is eliminated by the kidney’s collecting system (known as the renal pelvis) and travels down through tubes, called ureters, into the urinary bladder. Urine is stored in the urinary bladder until it is full and the person urinates.

When the bladder is removed, the ureters need to be surgically connected to some type of urinary diversion to drain urine.  All forms of urinary diversion use a part of the body's intestinal tract.

This surgery can be performed to have the urine drain into an opening in the abdomen in either a continent or incontinent fashion, or can drain through the urethra (the tube in the penis/vagina) in a continent fashion.  These options should be discussed with your physician.

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