Bladder, ureter & renal pelvis


Urinary diversion / neobladder

Last author update: 1 July 2011
Last staff update: 18 November 2021

Copyright: 2003-2023,, Inc.

PubMed Search: Urinary diversion[title]

Monika Roychowdhury, M.D.
Page views in 2022: 340
Page views in 2023 to date: 384
Cite this page: Roychowdhury M. Urinary diversion / neobladder. website. Accessed November 29th, 2023.
Definition / general
  • Portions of ileum or colon used in adults and children to treat congenital anomalies, dysfunctional bladder or post-cystectomy for malignancy
  • Options are to enlarge capacity of bladder (augmentation), channel urine into temporary artificial reservoir while a new bladder is being created or create a neobladder (new bladder after cystectomy)
    Patients who must have their bladder removed usually have three options for urine elimination:
    1. Ileal Conduit (Urostomy) – Conduit of small intestine or colon carries the urine to an opening on the abdomen
    2. Orthotopic neobladder – Neobladder made from loops of intestine to store the urine and individual can void through normal channels
    3. Continent urinary diversion – Creation of an internal pouch from loops of intestine which is connected to an opening on the abdomen through a “one way” passage
Clinical features

  • Intestinal adenocarcinoma in colonic conduits, reflux but only rare renal failure in ileal conduits, highest risk of adenocarcinoma is in augmentation cystoplasty (J Urol 1997;157:482)
  • Frequent complications but low reoperation rate in conduit urinary diversion (J Urol 2011;185:562)
  • Monitor for carcinoma with cytology (direct smears after centrifugation)
  • Note: must also monitor nonfunctionalized bladder, if present (J Urol 2006;176:620)
Case reports
Clinical images

Images hosted on other servers:

Continent urinary diversion using ileum

Microscopic (histologic) description
  • Inflamed, atrophic and partially denuded epithelium
  • Candida in ileal conduits
Microscopic (histologic) images

Images hosted on other servers:

Tubular adenoma with
high grade dysplasia
after augmentation

Differential diagnosis
  • Normal intestinal cells: aggregates are normally present in urinary diversion specimens, may resemble malignancy
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