Cancer of the urethra occurs rarely, with only around 700 cases reported worldwide annually, the University of Rochester Medical Center reported in 2010. The urethra and often the bladder are removed in advanced disease. After urethral removal, a method of diverting urine from the kidneys to outside the body is created. Two types of diversionary devices--an ileal conduit urinary diversion that drains continually or a continent pouch reservoir that collects urine and allows emptying when needed--can be created. Each involves use of part of the intestine to create a diversionary device. Complications can occur.
Pyelonephritis
Creation of tube leading from the ureters, which drain urine made by the kidney, to the outside world leaves a potential path for infection of the kidney, called pyelonephritis. Signs of kidney infection include chills, fever, foul-smelling urine, bloody urine, flank pain and generally feeling ill. Antibiotics will cure pyelonephritis, which may require hospitalization. Around 12 to 13 percent of patients with urostomy experience pyelonephritis at some time, the Encyclopedia of Surgery warns.
Conduit Complications
Obstruction or narrowing in the conduit created from the intestine that carries urine can occur from scarring. Obstructions can lead to urinary retention with abdominal pain, bloating and nausea, the University of California San Francisco reports.
Skin Complications
A urostomy that doesn't have a reservoir but that drains continually into a bag attached to the stoma, the opening into the small intestine through the skin, can cause skin irritation. Draining the bag regularly to prevent leakage, achieving a good seal to the skin by assuring that the skin is dry before applying the bag and checking for allergic reactions to adhesive seals or certain types of bags help prevent skin irritation, the United Ostomy Association recommends. Urinary crystals that form on the stoma are a sign of alkaline urine, which can cause irritation and bleeding of the stoma. Keeping the urine acidic rather than alkaline by increasing fluid intake to eight to ten glasses of water daily, drinking cranberry juice and taking vitamin C daily also help.
