UNJ October 2001

Urinary diversion involves providing an alternate path for urine to exit the body other than the normal ureter, bladder, urethra route. This can be accomplished by creating a pouch for collecting urine that then exits through a stoma, or by diverting the ureters to a stoma and allowing urine to free-flow through an opening in the abdomen. The first urinary diversion involved creation of a fistulous tract, the ureteroproctostomy, in a patient in 1851 (Razor, 1993). It was not until the early 20th century that the ureterosigmoidostomy became the first true form of continent urinary diversion and was, at the time, standard procedure. This procedure was eventually abandoned due to the high incidence of long-term complicaThe nurse plays an important part in the preoperative and postoperative management of the patient with a urinary diversion. Although urinary diversion as a surgical alternative has been performed since the mid 1800s, improvements in technique and management over the past 10 years warrant discussion. Three types of urinary diversion procedures are discussed along with suggestions for optimal nursing management during the postoperative period.