Urostomy: A Comprehensive Guide to Urinary Diversion Surgery
Updated: 3 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 17, 2026
TL;DR: A urostomy is a surgical procedure that creates a new path for urine to exit the body through a stoma in the abdomen [1]. This life-changing surgery is typically performed when the bladder is removed or severely damaged, most commonly due to bladder cancer [1]. While it represents a permanent change in how the body eliminates waste, modern surgical techniques and supportive care allow individuals to maintain an active and fulfilling lifestyle following their recovery.
Quick Answer
A urostomy is a urinary diversion surgery that creates a permanent opening, called a stoma, in the abdominal wall so urine can leave the body [1]. A surgeon typically uses a small piece of intestine to connect the ureters to the stoma, and urine collects in an external pouch [1]. It is used for bladder cancer, severe trauma or congenital defects [1].
What the research says
Ileal conduit has good long-term results. A systematic review of 16 studies (8,493 patients) found that, five or more years after bladder removal, the ileal conduit was associated with fewer urinary stones and better global health scores, while orthotopic neobladder was associated with better urinary function and body image (According to PubMed, Abusal et al., Cureus, 2025) [2].
Different diversion types trade off quality of life and complications. In a meta-analysis of 11 studies, ileal conduit showed better physical quality of life, particularly compared with bilateral-stoma cutaneous ureterostomy, but a higher risk of wound infection (OR 3.02) and early pyelonephritis (OR 3.04), especially compared with single-stoma cutaneous ureterostomy (Tjiaman et al., Urology, 2025) [3].
Robotic and open surgery have similar safety. Across 5 randomized trials (541 patients), robot-assisted and open cystectomy with extracorporeal urinary diversion had equivalent 90-day complications (RR 0.95, 95% CI 0.83–1.07; moderate certainty); robotic surgery reduced blood loss but took longer (Orakzai et al., J Robot Surg, 2026) [4].
What Is a Urostomy?
Urostomy surgery is a critical intervention for individuals facing severe urinary system challenges. By diverting the flow of urine, this procedure ensures that the body can safely eliminate waste even when the bladder is no longer functional. Although the transition to living with a stoma requires adjustment, it often provides a significant improvement in quality of life for those suffering from chronic pain, incontinence, or life-threatening diseases like cancer.
Indications for Urostomy
There are several medical reasons why a healthcare provider might recommend a urostomy. The most frequent indication is the removal of the bladder, known as a cystectomy, which is often necessary to treat invasive bladder cancer. Other reasons include significant damage to the bladder from trauma or radiation, severe urinary incontinence that cannot be managed by other means, and congenital conditions such as spina bifida. In some cases, spinal cord injuries or structural abnormalities in the urinary tract may also necessitate this procedure [1].
Indication | Description |
Bladder Cancer | The most common reason for bladder removal and urostomy. [1] |
Trauma | Severe injury to the bladder or urinary tract. [1] |
Congenital Defects | Conditions like spina bifida present from birth. [1] |
Chronic Disease | Bladder damage resulting from long-term disease or radiation. |
Urethral Damage | Injuries or abnormalities affecting the tube that carries urine out. [1] |
Types of Urostomy Procedures
Surgeons utilize different techniques to create a urinary diversion, depending on the patient's specific needs. The most common method is the ileal conduit, where a small segment of the ileum (part of the small intestine) is used to create a channel between the ureters and the stoma [1]. A similar approach, the colonic conduit, uses a piece of the colon instead [1]. In a ureterostomy, the ureters are connected directly to the stoma without using an intestinal segment [1]. Each type aims to provide a reliable and continuous path for urine drainage.
The Surgical Experience
Urostomy surgery is a complex procedure performed under general anesthesia and can last up to six hours [1]. During the operation, the surgeon creates the stoma at a pre-determined, easy-to-reach location on the abdomen [1]. Depending on the underlying cause, the surgeon may also remove the bladder and nearby organs such as the prostate or uterus [1]. Patients typically remain in the hospital for about three to seven days, sometimes longer, where they receive pain management and begin learning how to care for their new stoma and urostomy bag [1].
Recovery and Daily Management
Recovery from a urostomy involves both physical healing and learning new self-care routines. In the hospital, healthcare teams encourage early movement, such as walking, to prevent complications like blood clots or pneumonia [1]. Once home, it may take approximately two months before a person is ready to return to work or school [1]. Managing a urostomy involves emptying the collection bag regularly—similar to how often one would normally use the bathroom—and maintaining the skin around the stoma to prevent irritation.
Long-Term Outlook and Support
While a urostomy is almost always permanent, most people successfully adapt to the change. The stoma itself has no nerve endings and does not feel pain once the surgical site has healed [1]. Over time, the stoma typically becomes smaller and lighter in color [1]. Engaging with support groups and meeting regularly with healthcare providers during the first six months can provide valuable guidance and emotional support. With proper care, individuals with a urostomy can continue to participate in most of their usual activities, including exercise and travel.
Conclusion
A urostomy is a vital surgical solution that allows individuals with compromised urinary systems to lead healthy, active lives. Through professional surgical care and diligent stoma management, patients can navigate this transition with confidence. Understanding the procedure and utilizing available support systems are key steps toward achieving a successful long-term outcome.
Frequently Asked Questions
Do you still pee normally after a urostomy?
No, urine no longer leaves the body through the urethra. Instead, it drains continuously from the stoma into a collection bag attached to your abdomen.
Is a urostomy permanent?
In almost all cases, a urostomy is a permanent procedure that cannot be reversed, as it involves significant changes to the urinary tract.
Does the stoma hurt?
The stoma itself has no nerve endings and does not have any sensation. While the surgical wound around it may be sore during healing, the stoma itself is painless.
How often should I empty my urostomy bag?
You should empty the bag about as often as you would normally go to the bathroom, typically when it is one-third to one-half full.
Can I still exercise with a urostomy?
Yes, once you have fully recovered from surgery, you can return to most physical activities, including swimming, running, and other forms of exercise.
What does a healthy stoma look like?
A healthy stoma is typically red or pink and moist, similar to the inside of your mouth. It may be flat or slightly protruding from the skin.
Will people be able to see my urostomy bag under my clothes?
Modern urostomy bags are designed to be discreet and lay flat against the body, making them virtually unnoticeable under most types of clothing.
What are the risks of urostomy surgery?
Potential risks include infection, blood clots, pneumonia, and complications related to anesthesia, as well as long-term issues like skin irritation or hernias.
How long is the recovery period after surgery?
Some patients leave the hospital after about three days, while others stay as long as seven days or longer. Most people need about two months of recovery at home before returning to work or school.
Should I join a support group?
Many people find it very helpful to join a support group to share experiences and learn practical tips for living with a urostomy from others in similar situations.
Related Reading
Ureterostomy: Purpose, Procedure, Care and Recovery explains ureterostomy.
Pelvic Exenteration: Types, Surgery and Recovery explains pelvic exenteration surgery.
Loopogram: How It Checks Your Ileal Conduit After Bladder Removal explains the X-ray test that checks urine drainage through an ileal conduit.
References
Cleveland Clinic. Urostomy: Purpose, Procedure, Risks & Recovery. Cleveland Clinic. Last updated 04/30/2025. https://my.clevelandclinic.org/health/treatments/22476-urostomy
Abusal F, Alawadi A, Akpala A, Obeidat S, Al-Omari N, Alsharief M, Shalaby A, Shaukat Z, Sarkar D. Long-term complications and quality of life after urinary diversion for bladder cancer: a systematic review and meta-analysis. Cureus. 2025;17(5):e84744. PMID 40551917. https://doi.org/10.7759/cureus.84744
Tjiaman MP, Zaidan MZ, Ausath ZF, Putri AT, Tjiaman AS, Achmadsyah A, Mediana E, Hamid ARAH. Quality of life and postoperative complications of single- or bilateral-stoma cutaneous ureterostomy compared to ileal conduit after radical cystectomy: a systematic review and meta-analysis. Urology. 2025;207:287-292. PMID 41015301. https://doi.org/10.1016/j.urology.2025.09.034
Orakzai FK, Mirza W, Khan ME, Iqbal H, Khan A, Moeen-Ud-Din MB, Iqbal MW, Khan HM. Robot-assisted versus open radical cystectomy with extracorporeal urinary diversion for bladder cancer: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials with subgroup analyses by orthotopic neobladder utilisation. J Robot Surg. 2026;20(1):151. PMID 41486201. https://doi.org/10.1007/s11701-025-03135-1
Medical disclaimer
This article is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions about a medical condition.
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