A continent urinary diversion provides a reservoir for the urine that can be drained every few hours by a catheter inserted by the patient. A segment of bowel is used to create a pouch inside the abdomen into which the urine drains. A small channel is then created that connects the pouch to the abdominal wall.
This channel has a valve mechanism that prevents the urine from leaking. The channel is just large enough for a small catheter to be passed through it into the pouch. The pouch must be drained every 4 hours or so to prevent it from becoming overdistended. Overdistension can cause leakage or even rupture of the pouch.
Because the pouch is made of intestine, it may develop a buildup of mucous. To prevent this, it may need to be irrigated regularly with saline. Continent urinary diversions are associated with stone formation. Because the entrance to the pouch is through only a long, narrow channel, treatment of the stones can be difficult. Other risks include obstruction where the ureters are attached to the pouch and stricture or damage to the catheter channel, requiring surgical revision.
The advantages of a continent urinary diversion include not having a bag on the abdomen and a small stoma that is flush with the skin. Thus, it is cosmetically more appealing to some patients.