Ureterostomy, cutaneous


A cutaneous ureterostomy, also called ureterocutaneostomy, is a surgical procedure that detaches one or both ureters from the bladder, and brings them to the surface of the abdomen with the formation of an opening (stoma) to allow passage of urine.


The bladder is the membranous pouch that serves as a reservoir for urine. Contraction of the bladder results in urination. A ureterostomy is performed to divert the flow of urine away from the bladder when the bladder is not functioning or has been removed. The following conditions may result in a need for ureterostomy.


Bladder disorders afflict millions of people in the United States. According to the American Cancer Society (ACS), there were 54,200 new cases of bladder cancer in 1999, with approximately 12,100 deaths from the disease. Bladder cancer incidence is steadily rising, and by 2010 it is projected to increase by 28% for both men and women.


Urostomy is the generic name for any surgical procedure that diverts the passage of urine by re-directing the ureters (fibromuscular tubes that carry the urine from the kidney to the bladder). There are two basic types of urostomies. The first features the creation of a passage called an "ileal conduit." In this procedure, the ureters are detached from the bladder and joined to a short length of the small intestine (ileum). The other type of urostomy is cutaneous ureterostomy. With this technique, the surgeon detaches the ureters from the bladder and brings one or both to the surface of the abdomen. The hole created in the abdomen is called a stoma, a reddish, moist abdominal protrusion. The stoma is not painful; it has no sensation. Since it has no muscles to regulate urination, urine collects in a bag.

There are four common types of ureterostomies:


Ureterostomy patients may have the following tests and procedures as part of their diagnostic work-up:

The quality, character, and usable length of the ureters is usually assessed using any of the following tests:

The pre-surgery evaluation also includes an assessment of overall patient stability. The surgery may take from two to six hours, depending on the health of the ureters, and the experience of the surgeon.


After surgery, the condition of the ureters is monitored by IVP testing, repeated postoperatively at six months, one year, and then yearly.

Following ureterostomy, urine needs to be collected in bags. Several designs are available. One popular type features an open bag fitted with an anti-reflux valve, which prevents the urine from flowing back toward the stoma. A urostomy bag connects to a night bag that may be attached to the bed at night. Urostomy bags are available as one- and two-piece bags:


The complication rate associated with ureterostomy procedures is less than 5–10%. Risks during surgery include heart problems, pulmonary (lung) complications, development of blood clots (thrombosis), blocking of arteries (embolism), and injury to adjacent structures, such as bowel or vascular entities. Inadequate ureteral length may also be encountered, leading to ureteral kinking and subsequent obstruction. If plastic tubes need inserting, their malposition can lead to obstruction and eventual breakdown of the opening (anastomosis). Anastomotic leak is the most frequently encountered complication.

Normal results

Normal results for a ureterostomy include the successful diversion of the urine pathway away from the bladder, and a tension-free, watertight opening to the abdomen that prevents urinary leakage.

Morbidity and mortality rates

The outcome and prognosis for ureterostomy patients depends on a number of factors. The highest rates of complications exist for those who have pelvic cancer or a history of radiation therapy.

In one study, a French medical team followed 69 patients for a minimum of one year (an average of six years) after TUU was performed. They reported one complication per four patients (6.3%), including a case requiring open drainage, prolonged urinary leakage, and common ureteral death (necrosis). Two complications occurred three and four years after surgery. The National Cancer Institute performed TUU for pelvic malignancy in 10 patients. Mean follow-up was 6.5 years. Complications include common ureteral narrowing (one patient); subsequent kidney removal, or nephrectomy (one patient); recurrence of disease with ureteral obstruction (one patient); and disease progression in a case of inflammation of blood vessels, or vasulitis (one patient). One patient died of sepsis (infection in the bloodstream) due to urine leakage at the anastomosis, one died after a heart attack, and three died from metastasis of their primary cancer.


There are several alternative surgical procedures available:

See also Nephrostomy ; Open prostatectomy ; Transurethral resection of the prostate .



Door Mullen, B. & K. A. McGinn. The Ostomy Book: Living Comfortably With Colostomies, Ileostomies, and Urostomies. Boulder, CO: Bull Publishing Co., 1992.

Jeter, K. F. Urostomy Guide. Irvine, CA: American Urological Association, code 05-006.


Cedillo, U., C. Gracida, R. Espinoza, and J. Cancino. "Vesical Augmentation and Continent Ureterostomy in Kidney Transplant Patients." Transplant Proceedings 34 (November 2002): 2541-2.

Hiratsuka, Y., T. Ishii, H. Taira, and A. Okadome. "Simple Correction of Ureteral Stomal Stenosis for Cutaneous Ureterostomy." International Journal of Urology 10 (March 2003): 180-1.

Purohit, R. S., and P. N. Bretan, Jr. "Successful Long-term Outcome Using Existing Native Cutaneous Ureterostomy for Renal Transplant Drainage." Journal of Urology 163 (February 2000): 446-9.

Yoshimura, K., S. Maekawa, K. Ichioka, N. Terada, Y. Matsuta, K. Okubo, and Y. Arai. "Tubeless Cutaneous Ureterostomy: The Toyoda Method Revisited." Journal of Urology 165 (March 2001): 785-8.


American Urological Association (AUA). 1120 North Charles Street, Baltimore, MD 21201. (410) 727-1100. http://www.auanet.org .

United Ostomy Association (UOA). 19772 MacArthur Blvd., #200, Irvine, CA 92612-2405. (800) 826-0826. http://www.uoa.org .

Monique Laberge, Ph.D.


Ureterostomy is performed in a hospital setting by experienced surgeons trained in urology, the branch of medicine concerned with the diagnosis and treatment of diseases of the urinary tract and urogenital system. Specially trained nurses called wound ostomy continence nurses (WOCN) are commonly available for consultation in most major medical centers.


User Contributions:

George Johnston
What affedt would this procedure have on longevity and would it be a reason for an insurance life insurance company to decling coverage. There are other complications but I am asking about the mortality aspect. Thank you...
Carmen Gracida MD
I am co author of this article,I really think that continent ureterostomy is a very good option in patients with urologycal problems and kidney transplantation. therea are few reports about this topic.
All of this is very scary. I'm a spinal cord injury and anything unnatural is scary. I had a chimney from my bladder to a stoma on my stomach. Most of the time it worked great and then sometimes the urine wouldn't come through like it should and I would get sick about once a year and have to have iv antibiotics. I also felt very badly when the urine didn't come through like it should. I had it taken down because of the above. A urologist suggested a urterostomy but I don't know. Lots and lots and lots and lots and lots and lots and lots of prayer. Take care all. God Bless.
I have read your piece regarding urterostomy I have had a urterostomy for forty five years. It was done in 1967 when I was three years old I have grown up with it and am now married with two teenage children of my own. I have had no problems except for a few UTIs which need to be kept in check. I have had a very normal life and to see me you would not guess I had anything at all.

I have done everything I was told not to do as a child back then I was the first child in europe to have this operation not sure if I am the longest person alive with a urterostomy. Hope this helps

I was interested in your comment. You had a ureterostomy, not a illeum urinary diversion? I too have had a urinary diversion since age 3, so 45 yrs it has been on me. Now I am told that it needs to be redone. I am scheduled for Nov and they are talking about a ureterostomy instead of the illeum which I have now. What I read is that this closes off since it is so little and no mucas coming through like with the illeum. I am also told it is very small this stoma from a ureterostomy. Can you comment any further on if you have had trouble with it closing off at the stoma since it is so small and urine is sticky.
My son is 8months old and has his ureterostomy surgery performed at 13days old. I havent had any trouble with his stoma and it is very easy to keep clean ect. I use a zync based nappy rash cream on the skin around but away from the actual stoma to prevent the skin from becoming irritated.. My Sons urine isnt really sticky at all,it flows on its own and sometimes gushes but no trouble with it closing off at the stoma. I was given the option of using urine bags but i can never seems to time it good enough to have his skin all clean and nice and dry then have time to place the bag perfectly over the stoma ect ect with out him weeing everywhere so i just use junior size nappies (diapers) around his belly/waste with all the tabs teared off and a few bits of paper tape to tape it closed around his belly. Im sure for a full grown adult it would be a lot less hassle. I have never heard of a ureterostomy closing off at the stoma before.
Nelson Sllaunwhite
I had surgery four months ago and have a cutaneous ureterostomy . The stents were replaced about 90 days ago, I had bleeding after that for
over three weeks! It finally stopped every day but I am still getting blood off and on with clots. I am wondering if this is normal and can I
expect this to happen with every stent replacement?
My son has sever hydronephrosis in his right kidney from birth, so we performed urethrostomy operation of it. After operation urine started coming from stoma ,but after one month of surgery now urine completely stopped coming out of stoma, any idea why urine stopped coming out of stone,my surgeon not giving any satisfactory response

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