The surgical creation of a urinary diversion is necessary for managing diseases affecting the urinary tract. This national position statement supports health care professionals, including surgeons, Nurses Specialized in Wound, Ostomy and Continence (NSWOC) and urology nurses with the delivery of standardized clinical best practices for the pre- and postoperative care management of patients undergoing a urinary diversion.1
A task force convened comprising of 32 healthcare professionals from the Canadian Urological Association (CUA), Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC) and Urology Nurses of Canada (UNC). Search terms with inclusion and exclusion criteria were determined with a literature review conducted in February 2020 through Queen�s University. The committee reviewed 258 identified articles and retained 174 relevant for the project. Article review summaries were organized by the five urinary diversions and preoperative/HRQOL. Six smaller teams developed section content. The full task force reviewed drafts of the manuscript.
Thirty interprofessional peer reviewers provided input through Survey Monkey during November 2021. Overall, 89% of the reviewers would recommend this position statement to colleagues and administrators to support urinary diversion practices in Canada. Task force members discussed overall results, insights, and refinements. This position statement is endorsed by the CUA & UNC.
The position statement provides practitioners with:
1. A review of preoperative counselling & health-related quality of life considerations
2. A detailed examination of urinary diversion pathways
3. A quick reference guide to the five urinary diversions
4. The Ottawa decision tool to assist applicable patients in choosing between an ileal conduit and neobladder2
5. The validated Urostomy Education Scale to evaluate patient urostomy self-care skills3
6. An abridged preoperative site marking steps
7. An enhanced recovery checklist for an ileal conduit to standardize patient care and education
Practitioners should strive to work within an interprofessional team involving an NSWOC, urology nurse, physician, and other allied health professionals to support the patient and significant others. This position statement reinforces the fundamental principles enabling health care practitioners to educate and counsel patients on the various urinary diversion options.
Canadian Urinary Diversions Position Statement: Collaboration of Canadian Urological Association, Nurses Specialized in Wound, Ostomy and Continence Canada & Urology Nurses of Canada. (1st ed.) 2022.