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Ureterostomy
Ureterostomy is surgery that redirects urine from one or both ureters to an opening in the skin (a stoma), so it drains into an external pouch instead of passing through the bladder. It's used when the bladder is removed or can't work safely, or when a blocked urinary tract is putting the kidneys at risk.
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Briefly about this treatment
Indications
Bladder removal (most often for bladder cancer), a bladder that can't store or empty urine safely, or a blocked or widened ureter that threatens kidney function.
Risks
Bleeding, infection, skin irritation around the stoma, and narrowing of the stoma over time. Risks are reduced by careful patient selection, an experienced surgical team, and good stoma care.
Pre-procedure
Kidney function and blood tests, imaging (ultrasound, CT or MRI), anesthesia assessment, and a visit with a stoma nurse to choose the best stoma site. Fasting per hospital protocol.
Follow-up
Early visits to check the wound, stoma and stents, then long-term monitoring of kidney function and the stoma, with stoma-nurse support whenever you need it.
What is Ureterostomy? An expert explains
A ureterostomy — also called a cutaneous ureterostomy — is one type of urinary diversion. Unlike the more common ileal conduit, it doesn’t use a piece of your bowel: the ureter is connected straight to your skin. You can have one side redirected (unilateral, while the other ureter keeps draining into your bladder as normal) or both sides redirected (bilateral). It’s also different from a nephrostomy, which drains a kidney through a tube placed with imaging guidance rather than through a surgical stoma, and is usually meant to be temporary.
Signs it may be time for Ureterostomy
No single symptom means you need this surgery. It’s considered when a problem in the bladder or ureters is putting your kidneys at risk. Signs you might notice or feel include:
- Flank or back pain. A dull ache or sharp pain on one or both sides, often caused by urine backing up toward the kidney.
- Repeated urinary tract infections. Fever, burning, or cloudy, strong-smelling urine that keeps coming back despite treatment.
- Blood in the urine. Urine that looks pink, red, or brown.
- Trouble emptying your bladder, or constant leaking. A weak or absent stream, a feeling that your bladder never fully empties, or dribbling you can’t control.
- Signs your kidneys are struggling. Passing noticeably less urine, swelling in your legs or ankles, unusual tiredness, or nausea.
Many of these have common, treatable causes, so they’re a reason to get checked rather than a reason to worry.
Conditions linked to ureterostomy
These are the conditions where a ureterostomy is most often discussed:
- Hydronephrosis — swelling of the kidney when urine can’t drain; a ureterostomy gives it a clear way out.
- Obstructive uropathy — any blockage in the urinary tract that affects how well your kidneys work.
- Neurogenic bladder — nerve problems, for example after a spinal cord injury or from spina bifida, that stop the bladder emptying properly.
- Bladder cancer (upper tract obstruction) — when the bladder has to be removed or a tumor blocks urine from leaving the kidneys.
- Megaloureter — a widened ureter, most often in children, where temporary drainage can protect the kidney.
When to consult a specialist
If some of these signs sound familiar, try not to worry. Most have common, treatable causes, and noticing them early gives you the most options. A simple blood test (creatinine and eGFR) and a urine test can show how your kidneys are doing, and an ultrasound can show whether urine is draining properly. You don’t need a diagnosis to ask questions. A urologist or nephrologist can go through your results with you and tell you whether a ureterostomy is even relevant for you. When you’re ready, you can find a specialist on KidneyGlobal and book a consultation.
How a session works
A ureterostomy is a one-time operation, not a series of sessions. On the day:
- Preparation. You arrive fasting, the team confirms your tests, and the stoma site is marked while you’re awake — somewhere you can see and reach, away from your belt line or a skin fold.
- The operation. Under anesthesia, the surgeon disconnects one or both ureters from the bladder and brings them through the abdominal wall to form the stoma. Depending on your case, this is done alone or together with bladder removal (cystectomy), on one side or both. In some bilateral cases both ureters are joined to a single stoma so you only wear one pouch.
- Waking up. You’re monitored in recovery, then moved to a ward.
Session duration
1–3 hours
recorded for this treatment
Cost verify
$5000–$10000
indicative range
Anesthesia
General
recorded for this treatment
Remember: The exact steps, duration and preparation can vary with your indication, health and care setting. Confirm the current plan with your treating team.
Benefits
A ureterostomy gives urine a safe way out when the bladder can’t do that job. For many people that means protecting the kidneys and feeling more in control of a difficult situation.
- Protects your kidneys. When urine can leave freely, it stops backing up and putting pressure on the kidney.
- Fewer urinary infections. Clearing a blockage or bypassing a bladder that doesn’t empty reduces the stagnant urine that infections thrive in.
- A simpler operation than bowel-based diversions. Because no bowel is used, studies describe shorter operating time, less blood loss, and a shorter hospital stay than an ileal conduit, which can matter if you’re frail or have other health conditions.
- Can be temporary in children. In babies and young children, it can buy time to protect the kidney until a lasting repair is possible.
Risks & side effects
A ureterostomy has risks and trade-offs to discuss with your care team. The information below is a general overview of this treatment, not a prediction for you.
Bleeding, infection, skin irritation around the stoma, and narrowing of the stoma over time. Risks are reduced by careful patient selection, an experienced surgical team, and good stoma care.
- Pain and tenderness. Soreness around the wound and stoma is expected in the first weeks and is managed with pain relief.
- Bleeding or infection. As with any operation, the wound or urinary tract can become infected, and bleeding can occur during or after surgery.
- Skin irritation. Urine that leaks under the pouch can make the skin around the stoma red, sore, or crusty, which is why a well-fitting pouch matters.
- Hernia or scar tissue. A bulge can develop near the stoma, and scar tissue can form around the opening.
- Emotional adjustment. Feeling self-conscious about the stoma, or worried about how it changes daily life, is common. Your stoma nurse and support groups can help.
Who it may not suit: A ureterostomy can be harder in people whose ureters are very short or have a poor blood supply, or who have had pelvic radiation, where complication rates are higher. These are general cautions, not a personal verdict. A qualified clinician must assess your full medical picture before recommending or delaying treatment.
What happens during & after
During. You’re asleep and feel nothing. The team monitors your breathing, heart rate, and blood pressure throughout. Thin tubes called stents are usually placed in the ureters to protect the healing connection, and they’re removed at a follow-up visit once things have settled.
After, in hospital. You’ll have pain relief and regular checks of the stoma and your urine output. Before you go home, a stoma nurse teaches you to clean the stoma, fit the pouch, and spot early warning signs.
After, at home. Your stoma has no muscle to open and close it, so urine drains continuously rather than on a schedule you control:
- A skin barrier (wafer) with a pouch sits over the stoma and collects urine.
- Most people empty the pouch about as often as they used the bathroom, usually when it’s one-third to one-half full.
- At night, the pouch can connect to a larger drainage bag so you don’t need to wake up to empty it.
- With a unilateral ureterostomy, the other kidney still drains into your bladder, so you pass urine both ways.
Possible complications
Most people do well over the long term, but some complications can develop, especially in the first year and in people who have had radiation or extensive pelvic surgery.
- Stoma narrowing (stenosis). The most discussed long-term issue. In research on children, narrowing at the end-type stoma was reported in roughly 8% to 22% of cases, and some needed a small procedure to widen it.
- Urine leakage. Urine can leak where the ureter was joined or connected, usually early on, and sometimes needs further drainage.
- Recurring infections. Without the bladder’s natural barrier, bacteria can travel to the kidneys more easily, causing kidney infections.
- Blockage and kidney swelling. If narrowing or scarring isn’t caught, urine can back up again (hydronephrosis) and reduce kidney function, which is why follow-up matters even when you feel well.
- Poor blood supply to the ureter. Rarely, the ureter doesn’t heal well and needs further surgery.
- Electrolyte imbalance. Uncommon, but reported after urinary diversion, and picked up on blood tests.
Remember:
New or severe symptoms require prompt medical advice. Do not wait for a routine appointment if you feel seriously unwell.
Recovery
Recovery after a ureterostomy is gradual, and learning to live with the stoma is part of it.
- In hospital: length of stay depends on your overall health and whether bladder removal was done at the same time, from a few days to around two weeks.
- First 4–6 weeks: avoid heavy lifting and driving until your surgeon clears you, so the wound and stoma can settle.
- Once healed: most people return to their usual routine, including swimming and other water sports. Full-contact sports are usually best avoided.
- Every day: wash the stoma and surrounding skin with mild soap and water, rinse well, and dry completely. Keep spare supplies with you when you’re out.
- Pouch changes: the skin barrier is usually changed every 5–7 days, or sooner if it leaks.
- Long-term follow-up: your urologist will schedule kidney function blood tests and imaging to make sure urine is draining well. If you already live with reduced kidney function, a nephrologist can share this monitoring.
Call your care team if the skin around the stoma breaks down or the stoma changes color, sinks, or swells.
Clinics offering Ureterostomy
Verified kidney centres linked to this treatment in the KidneyGlobal directory.
University Hospital
Urologic Oncology & Robotic Surgery
ISO 9001European Urology Boardda Vinci Robotic Center
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Academic Medical Center
Minimally Invasive Urologic Surgery
Joint CommissionNCI Cancer CenterRobotic Surgery Excellence
✓ 24/7 ER✓ ICU✓ Insurance
Academic Medical Center
Kidney Transplantation
Joint CommissionUNOS CertifiedLiving Donor Excellence
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Good questions
Most Common Questions
Is a ureterostomy the same as a urostomy?
Not quite. Urostomy is the umbrella term for any surgery that diverts urine through a new opening in the skin. A ureterostomy is one specific type; the ileal conduit, which uses a piece of bowel, is another and is performed more often.
Is a ureterostomy permanent?
Usually, yes, in adults. In some infants and children it's a temporary measure to protect the kidneys, and it can be reversed (undiversion) once the underlying problem is treated.
Will I feel pain from the stoma itself?
The stoma has very few pain-sensing nerves, so once it has healed it typically isn't painful. The skin around it can become sore if urine leaks under the pouch, which is why a good fit matters.
How is it different from an ileal conduit or a nephrostomy?
An ileal conduit builds a channel from a piece of bowel, while a ureterostomy connects the ureter directly to the skin. A nephrostomy is a drainage tube placed through the skin into the kidney itself and is usually temporary.
Can I swim, exercise, and travel with a ureterostomy?
Once you've healed, usually yes, including swimming. Full-contact sports are best avoided, and it helps to carry spare pouches and barriers when you travel.
Do I need a special diet?
A ureterostomy doesn't usually require a special diet. If you also have reduced kidney function, your care team may suggest dietary changes for that, which is a separate question from the stoma.
Sources
- Ureterostomy: Purpose, Procedure, Risks & RecoveryCleveland Clinic
- Urinary Reconstruction & DiversionCleveland Clinic
- Urinary DiversionNational Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
- Cutaneous ureterostomy in adultsPubMed, U.S. National Library of Medicine
- Cutaneous Ureterostomy: Indications in ChildrenJournal of Urology (via ScienceDirect, Elsevier)
- Analysis of the efficacy of a single subumbilical stoma for bilateral cutaneous ureterostomy after radical cystectomyEuropean Journal of Medical Research (BioMed Central / Springer Nature)
- Unilateral cutaneous ureterostomy vs ileal conduit after radical cystectomy (operative times)World Journal of Nephrology (Baishideng)
- Cutaneous urinary diversionHealthline