“Urologists who perform urinary diversions should not only be familiar with surgical techniques to create these diversions but should also be aware of metabolic changes that arise when intestinal segments are used to divert or to store urine. Many patients have a long life expectancy, even after oncological surgery with urinary diversion. The advance of medical care makes urinary diversion possible in older, less fit patients with impaired renal function. The duration of contact between urine and bowel, the segment and length of bowel used are factors that determine the nature and grade of metabolic effects. Diversion will result in immediate changes in metabolism.”

“The most popular diversions to date are made from ileal or ileocolonic segments. Noncontinent ileocutaneostomy or Bricker diversion is the most frequently used type of
diversion. This procedure was popularized by Bricker. In this procedure, a conduit is made from approximately 15 to 25 centimeters of preterminal ileum. Reasons for this
popularity over other types of diversion are the relative ease and simplicity of the procedure, the predictable functional results (no risk for incontinence, retention, and catheterization problems), and the fact that this type of diversion results in less metabolic changes (shorter bowel segment, no urinary storage).”