[Indications for different types of urinary diversion].

Area of Science:

• Urology
• Surgical Oncology

Context:

• Urinary diversion is a critical procedure following cystectomy or for other indications.
• A wide array of urinary diversion techniques exist, categorized as incontinent (e.g., ureterocutaneostomy, ileal conduit) and continent (e.g., continent cutaneous, urethral substitution).

Purpose:

• To highlight the importance of comprehensive patient information regarding urinary diversion options.
• To outline the diverse choices available for both incontinent and continent urinary diversion.
• To detail the patient-specific and medical criteria influencing the selection of urinary diversion.

Summary:

• Patient preference, age, comorbidities, BMI, motivation, and the underlying disease/indication for cystectomy are key patient criteria.
• Medical criteria include renal function, upper urinary tract status, gastrointestinal tract limitations, urethral/sphincter status, and self-catheterization capability.
• Preoperative counseling, potentially using simulations of postoperative scenarios, empowers patients to select the most suitable urinary diversion.

Impact:

• Informed patient choice leads to improved functional outcomes and higher patient satisfaction.
• Tailoring the urinary diversion technique to individual patient circumstances maximizes success.
• This approach facilitates shared decision-making in complex urological reconstructions.