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The primary objective of urinary diversion is to allow low-pressure storage and efficient drainage of urine in patients with bladder cancer or severe lower urinary tract dysfunction. Continent urinary diversion, although more challenging to construct and less commonly performed than non-continent diversion, offers the advantages of an intra-corporeal pouch for urinary storage and a concealed stoma for evacuation. Minimally, invasive approaches to the creation of continent urinary diversions have emerged over the last 20 years and may limit the morbidity of these procedures by potentially allowing shorter hospitalization, earlier recovery, and improved postoperative pain control. We review the various advances in minimally invasive approaches to continent urinary diversion. [ABSTRACT FROM AUTHOR]

Techniques for continent cutaneous urinary diversion (CCD) have evolved considerably over the last 65 years. The Indiana pouch (IP) was initially described in the 1980s and has gained wide acceptance among urologists. For patients who desire continent urinary diversion, many clinical scenarios and individual preferences continue to make the IP an excellent option for appropriately selected patients. Continence rates for the IP are generally satisfactory and compare favorably with orthotopic neobladder. Unfortunately, radical cystectomy with urinary diversion is associated with a high complication rate. We discuss short-term (<90 days) and long-term complications for CCD with attention to specific complications related to the efferent limb and continent pouch. Finally, we discuss health-related quality of life (HRQOL) after IP urinary diversion with comparison to the orthotopic neobladder and conduit diversion. [ABSTRACT FROM AUTHOR]

Continent cutaneous urinary diversion can be employed after cystectomy when orthotopic diversion is not appropriate and a continent diversion is desired. It is a technically challenging operation and requires careful pre-operative and intra-operative planning as well as an experienced surgeon and ancillary staff. Overall, continent cutaneous diversion (CCD) carries a high rate of long-term continence and patient satisfaction, and is an important and widely accepted part of the urologist's armamentarium. Many different types of CCD and efferent channels have been described with variable success. Complications are largely related to the stoma and catheterizable channel. These complications can usually be managed outside of the operating room although occasionally re-operation is required. [ABSTRACT FROM AUTHOR]