Cutaneous urinary diversion is a procedure that involves making incisions into the skin to create a new pathway for urine to exit your body.

If your urinary tract doesn’t function well, you may need a urinary diversion procedure. Urinary diversion is a surgical procedure that allows urine to exit your body.

There are many kinds of urinary diversion procedures — some are cutaneous while others aren’t.

Cutaneous urinary diversion procedures can include:

The kind of urinary diversion surgery you have depends on factors such as your health and medical history, your mobility, and whether you can use a catheter.

Urine is made of waste and fluid. When you have difficulties urinating, waste may build up in your bladder or kidneys. This can cause pain and complications such as kidney stones or urinary tract infections (UTIs).

Urinary diversion allows your body to eliminate waste to avoid buildup.

Urinary diversion procedures are necessary when your urinary tract isn’t functioning on its own. This may be because you’ve had:

The cost of cutaneous urinary diversion can vary widely based on which procedure you have and where surgery occurs.

According to Medicare, cutaneous urinary diversion procedures cost an average of $1,948 when done in ambulatory surgical centers and $3,660 when done in hospital outpatient departments.

The exact cost will depend on the type of procedure that’s done. Follow-up care and postsurgical supplies, such as urostomy pouches, cost an additional fee.

Depending on your package, medical insurance may cover all or most of the costs relating to medically necessary surgeries, such as a cutaneous urinary diversion.

Medicare does cover urostomy procedures and may pay for up to 80% of the surgery. Medicaid may cover ostomy supplies such as urostomy bags.

If you have a stoma, urostomy pouch, or internal reservoir, there’s always a risk of infection.

Symptoms of infection include:

To reduce your risk of infection, you’ll need to care for your stoma carefully by cleaning it as directed. Always wash your hands thoroughly with soap and water before and after handling a urostomy pouch, catheter, or stoma.

Other potential risks of urinary diversion can include:

If you suspect you have an infection or another side effect, make an appointment to see a healthcare professional immediately.

Before a urinary diversion, your clinician will take a full medical history and explain your options for the procedure. They’ll also explain exactly what to expect during the surgery and how to prepare for the procedure.

You’ll likely be under general anesthetic during the procedure, so your doctor may advise you to stop eating and drinking 6 to 8 hours beforehand or avoid anything after midnight the night before your operation.

When preparing for the surgery, consider:

  • Taking time off work: Discuss how much time you’ll need off work with your clinician. While most people are back at work within 1 to 2 months of a urinary diversion, it depends on your health and job demands.
  • Having someone drive you home: After your surgery, you’ll need someone else to drive you home.
  • Having a loved one stay with you if you live alone: You might not need that much assistance after your surgery, but having company and support immediately after can be helpful.
  • Ways to make your life easier while you heal: Consider making or ordering frozen meals, making arrangements for child care assistance, and hiring people to assist with cleaning or gardening for the first few weeks.

Cutaneous urinary diversions happen under general anesthetic.

During a cutaneous ureterostomy, your surgical team will:

  • Create a stoma (an opening) in your abdominal wall.
  • Detach one or both ureters from the bladder.
  • Reconnect the ureter(s) to the stoma.
  • Attach an external pouch, called a urostomy bag, to the stoma.

During a continent cutaneous reservoir surgery, your surgical team will:

  • Create a stoma in your abdominal wall.
  • Cut a piece of bowel tissue and construct an internal pouch (or reservoir) from it.
  • Attach the reservoir to the stoma.
  • Detach one or both ureters from the bladder.
  • Reconnect the ureter(s) to the reservoir.

Your healthcare team will tell you exactly what to expect after a cutaneous urinary diversion. Your recovery will depend on the exact procedure you undergo as well as your own health.

On average, it takes up to 2 months for people to return to their usual work, hobbies, and other activities. After urinary diversion, you can travel as soon as you feel up for it.

While healing after cutaneous urinary diversion surgery, you may need to avoid vigorous activity, contact sports, and intensive exercise (especially involving heavy weightlifting). Once you heal, you can return to more intense exercise. It’s possible to swim and play watersports with a urostomy bag.

If your job is strenuous and requires heavy lifting, speak with a doctor about if and when you can return to it. You may need to adjust your job responsibilities or use padding or protective clothing to protect your stoma.

What aftercare is necessary after a cutaneous urinary diversion?

When you have a stoma, urostomy pouch, or continent cutaneous reservoir, it’s important to keep it clean and care for it in order to avoid infection. Your care team will teach you how to properly manage your urinary diversion.

If you have a urostomy pouch, urinary diversion aftercare can include:

  • cleaning the skin around your stoma frequently
  • emptying your urostomy pouch often (typically when it’s 1/3 to 1/2 full)
  • changing the pouch frequently (usually 1–2 times a week)

If you have an internal pouch or reservoir, urinary diversion aftercare can include:

  • cleaning the skin around your stoma frequently
  • emptying the internal pouch frequently (usually every 2–4 hours) by inserting a catheter through the stoma to drain the urine
  • flushing out the internal pouch frequently with water or saline using a syringe

If you have difficulties inserting your catheter, contact your medical care team right away to avoid urine building up in your body.

How does a cutaneous urinary diversion compare to other urinary diversion procedures?

“Cutaneous” means that it relates to the skin. Every urinary diversion procedure is different. Some are called cutaneous while others aren’t.

Do you have to change your diet after a cutaneous urinary diversion?

No, you typically don’t have to change your diet after urinary diversion surgery.

How do I care for my stoma after a urinary diversion?

To avoid infection, keep your stoma and the surrounding skin clean. You can wash the stoma and surrounding skin with warm water.

If you’d like to use soap, only use a mild soap that doesn’t contain fragrances, colorants, or alcohol. Be sure to rinse it thoroughly and pat the skin dry.

If you notice any signs of infection or irritation, contact a medical professional.

How long does it take to recover from a cutaneous urinary diversion?

This depends on your health and personal biology. However, you can expect to feel well and regain strength within 1 to 2 months. Most people return to work and regular activities within this time period.

Urinary diversions are necessary when your body can’t get rid of urine properly on its own. There are many kinds of urinary diversions. Cutaneous urinary diversions can be a suitable choice for many people.

If you have questions about your surgery, reach out to your care team.

Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.