URINARY-DIVERSION AFTER CYSTECTOMY - POSS IBILITIES AND LIMITS

Patients' quality of life after radical cystectomy essentially depends on the kind of urinary diversion. In principle, continent and noncont inent forms of urinary diversion are available. Among the continent di version techniques one has to distinguish between, first, the orthotop ic bladder substitution, i.e. a connection between the new bladder cre ated of bowel and the remaining urethra, secondly, the so-called pouch , i.e. an urinary reservoir being voided by clean intermittent cathete rization via a cutaneous urostoma, and, thirdly, the ureterosigmoidost omy, i.e. the implantation of the ureter into the colon sigmoideum res ulting in a combined urine-stool-reservoir. The noncontinent forms of urinary diversion consist of the so-called conduits in which the urine passes an urostoma via an interposed bowel segment (ileum or colon). In the present article, the development of the urinary diversion as we ll as the spectrum of the modern procedures of urinary diversion curre ntly offered are described.