Types of urostomies

There are 2 basic options for urostomy surgery: the standard or conventional urostomy and the continent urinary reservoir.

There are many factors that must be considered when deciding which type is needed. The surgeon will talk with you about which is best for you.

Standard or conventional urostomy

    Reasons surgery may be needed:

    Bladder cancer

    Neurologic dysfunction

    Birth defects

    Chronic inflammation of bladder

    Output:

    Urine and some mucus; will be continuous (non-stop) drainage

    Management:

    Skin protection is needed; will need a drainable, valve-end pouch that’s adaptable to night drainage

For this type of urostomy, an ileal conduit is made. An ileal conduit is a small pouch that holds urine. It’s surgically created from a small piece of bowel (intestine).

To make an ileal conduit, a 6- to 8- inch piece of the lower part of the small intestine (called the ileum) is cut out near where it attaches to the large intestine (colon). The rest of the ileum is then re-connected to the large intestine. The ureters are detached from the bladder and attached to the piece of ileum that was removed. The bladder may or may not be removed. The far end of the piece of ileum is brought through the front of the abdomen wall to form the stoma. The other end is sewed closed to make a pocket that holds the urine inside the body. This surgery is a life-long change. The urine output cannot be controlled and a collection pouch will have to be worn at all times.

Illustration showing location of a stoma in relation to the ascending colon, transverse colon, small intestine and descending/sigmoid colon

The small intestine produces mucus naturally. The segment of intestine that was used to form the ileal conduit or urine pocket will keep making mucus, too. The mucus will collect in the pouch along with the urine. This is normal.

Continent urostomies

For a continent urostomy, the surgeon also makes an internal pouch. In this case, the pouch has valves to keep the urine from backing up the ureters into the kidneys. There’s also a valve to keep the urine in the pouch until it’s removed. The pouch must be drained 4 or 5 times a day with a thin, flexible tube called a catheter. The doctor or ostomy nurse will teach you how to drain the pouch and help you make a schedule to do it.

Different types of continent urostomies:

illustration showing details of four types of urostomies: kock pouch, indiana pouch, mitrofanoff procedure and variation and ileal neobladder

In its original form this document was written by the United Ostomy Association, Inc. (1962-2005) and reviewed by Jan Clark, RNET, CWOCN and Peg Grover, RNET. It has since been modified and updated by:

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Last Medical Review: December 2, 2014 Last Revised: February 14, 2017

American Cancer Society medical information is copyrighted material. For reprint requests, please contact permissionrequest@cancer.org.