Urinary diversion surgery is a crucial procedure for patients whose bladder has been removed or is non-functional. One of the key aspects of this surgery is the creation of a stoma, which allows urine to exit the body. Understanding the different stoma types is essential for patients and healthcare providers alike. Here are the primary stoma types associated with urinary diversion surgery:

1. Ileal Conduit:
The ileal conduit is the most common type of urinary stoma. In this procedure, a small segment of the ileum (part of the small intestine) is used to create a conduit for urine. The surgeon connects the ureters (which carry urine from the kidneys) to this piece of ileum, which is then brought to the abdominal wall to form a stoma. Patients with an ileal conduit typically wear an external pouch to collect urine.

2. Continent Cutaneous Reservoir (Kock Pouch):
The continent cutaneous reservoir, also known as the Kock pouch, involves creating a pouch from a section of the ileum. This pouch is connected to the ureters and is placed inside the abdomen. The stoma is formed on the surface of the abdomen, and patients can self-catheterize to drain the urine from the pouch. This option allows for more control and offers a degree of continence for the patient.

3. Orthotopic Neobladder:
The orthotopic neobladder is a more complex procedure that creates a new bladder using a section of the ileum or colon. This neobladder is then connected to the urethra, allowing the patient to urinate in a manner similar to those with a native bladder. Although this method aims to restore normal urinary function, it may not be suitable for all patients, particularly those with other complicating health issues.

4. Ureterosigmoidostomy:
In a ureterosigmoidostomy, the ureters are connected directly to the sigmoid colon, allowing urine to flow into the colon and be expelled through the rectum. This method can provide a more natural route for urine elimination; however, it may be associated with complications, including urinary infections or incontinence.

5. Nephrostomy:
A nephrostomy is not as common as the other stoma types but can be necessary when other urinary diversion methods are not feasible. In this procedure, a tube is placed directly into the kidney pelvis, allowing urine to be drained externally through a stoma in the back. This option is usually temporary and is often employed in cases of obstruction or when immediate drainage is required.

Understanding the various stoma types for urinary diversion surgery is vital for patients and families navigating this journey. Each option has unique benefits and challenges, and the choice of stoma will depend on individual medical conditions, lifestyle considerations, and surgical recommendations. Consulting with a healthcare provider can help determine the most appropriate stoma type for an effective urinary diversion.