If your bladder is surgically removed (radical cystectomy), your surgeon will create a bladder substitute called a continent reservoir. (This procedure is also called a continent diversion.) A segment of your bowel is removed and used to create a storage pouch that is then attached inside your abdomen. There are two types of internal continent reservoirs.

• Abdominal diversion reservoir. The pouch inside the abdomen connects to an opening (stoma) in the skin. This procedure is called a urostomy. You will need to pass a catheter through the opening to release the urine several times a day and during the night.
• Orthotopic diversion. The pouch in this procedure is sometimes called a bladder substitution reservoir. If your urethra was not removed as part of the cystectomy, you may be able to have this type of procedure. In an orthotopic diversion, the pouch is attached to your ureters at one end and your urethra at the other. This allows you to pass urine through the same opening as you did before surgery. Some people may need to use a catheter to release the urine.

Continent reservoirs eliminate the need for a urine storage bag to be worn on the outside of the body.