This informative webinar explores the various urinary diversions available to individuals undergoing a radical cystectomy. This session, hosted by Leah Jamnicky, a nurse with over 38 years’ experience with the Division on Urology, provides an in-depth look at the different options, discussing the pros and cons of each. You’ll also gain valuable tips and tricks for managing daily life with a urinary diversion. Additionally, you will hear firsthand experiences from individuals living with each type of diversion, offering unique insights and practical advice.
What Are Urinary Diversions After Bladder Removal?
Urinary diversions are surgical methods that allow the body to store and pass urine after the bladder is removed due to bladder cancer. Each option varies in complexity, lifestyle impact, recovery time, continence, and level of daily management required. The webinar provides a comprehensive overview of ileal conduits, Indiana pouches, and neobladders, helping patients understand the differences before surgery and feel more confident about adapting afterward.
Types of Urinary Diversions
Ileal Conduit
The ileal conduit is the most common diversion after bladder removal. A small piece of the intestine is used to create a stoma on the abdomen, where urine drains continuously into an external pouch (ostomy bag).
Key points:
- Typically, shorter surgery and hospital stay (4–7 days)
- Requires pouch changes and regular stoma care
- Common challenges include skin irritation and risk of hernias
- Adjustment period is generally faster (around 3 months)
- Many patients travel and live active lifestyles with proper preparation
Indiana Pouch
The Indiana pouch is an internal reservoir created from intestinal tissue, accessed by inserting a catheter through a small stoma near the belly button.
Key points:
- Catheterizing every 2–4 hours is essential
- Longer hospital stay (5–10 days) and more complex surgery
- Supplies may be costly, especially catheter types
- Potential complications: leakage, strictures, metabolic changes
- Offers discreetness/ no external bag
Neobladder
A neobladder is formed from the intestine and connected to the urethra, allowing urination similar to a natural bladder.
Key points:
- Requires good dexterity and bladder training
- Challenges: nighttime incontinence, mucus buildup, incomplete emptying
- Post-surgery physiotherapy is often needed
- Typically offered to younger or healthier candidates
- Provides the most “natural” voiding experience, though still requires adaptation
Recovery, Adjustment, and Daily Living with Urinary Diversions
Regardless of the diversion type, patients should expect an adjustment phase. Ileal conduit users often adapt most quickly, while those with continent diversions (Indiana pouch and neobladder) may need 9–12 months to establish routines and regain confidence.
Lifestyle and daily management topics covered in the webinar include:
- Creating pouch-change or catheterization routines
- Preventing infections and maintaining hydration (up to 3L/day)
- Traveling with supplies and using medical alert bracelets
- Managing mucus buildup and understanding metabolic risks
- Recognizing signs of complications like strictures, hernias, or leakage
Sexual Health, Emotional Well-Being, and Financial Considerations with Urinary Diversions
Urinary diversions can affect sexual function, body image, and confidence. The webinar openly discusses:
- Nerve-related erectile dysfunction in men
- Vaginal changes affecting comfort and orgasm in women
- Importance of communication with healthcare teams
- Emotional support from peers and counselors
- Costs associated with appliances, catheters, and supplies
- Available financial supports, including tax credits and funding programs
Real Experiences from Patients Living with Diversions
Real patients Gloria, Clarence, and Dave share what daily life looks like with each type of urinary diversion:
- Gloria (Neobladder): Highlights pelvic floor physiotherapy, patience, and long-term travel success
- Clarence (Ileal Conduit): Emphasizes manageable routines and finding the right appliance fit
- Dave (Indiana Pouch): Values the discrete nature of his diversion and relies on strict schedules
These personal stories help demystify life after surgery and provide encouragement for those preparing for or recovering from a cystectomy.
Making the Right Decision for You
Choosing a urinary diversion involves considering many factors, like tumor characteristics, kidney function, physical abilities, lifestyle preferences, and financial realities. The webinar reinforces the importance of partnering with your care team, asking questions, and accessing reliable education and peer support.
Learn More and Find Support Through Bladder Cancer Canada
Bladder Cancer Canada is here to help you navigate life after bladder removal with trustworthy educational resources, compassionate peer connections, and practical tools for recovery. Whether you’re preparing for surgery, adjusting to a diversion, or seeking long-term support, our community and programs are here for you.
