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Ileal conduit: how a urostomy works and what living with one involves | CION Cancer Clinics
An ileal conduit is a short piece of your own small bowel, used as a pipe to carry urine from the kidneys to an opening on the belly. A bag over that opening collects the urine. It is the most common diversion after bladder removal because it is the simplest to live with. This page explains how it is made, what the bag involves, and what it cannot tell you. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is an ileal conduit?
- How the conduit is made during the operation
- What living with a urostomy actually involves
- Words you will see, in plain language
- Four things families tell us, and what is actually true
- Who a conduit does not suit, and what this page cannot tell you
- Common questions about an ileal conduit
The short answer
What is an ileal conduit?
An ileal conduit is a short piece of your own small bowel, used as a pipe to carry urine from the kidneys to an opening on the belly. A bag worn over that opening collects the urine. It is the most common way of draining urine after the bladder has been removed, and the everyday name for it is a urostomy.
Why it is called a conduit and not a bladder
The bowel segment does not store urine. It is a channel, open at the skin end, so urine flows through it continuously into the bag. There is nothing to empty inside the body and nothing to control. That is why it is the simplest diversion to live with, and why a bag is needed.
Why the surgeon uses a piece of bowel
Bowel has its own blood supply and can be moved without harm. A short length near the end of the small bowel, the ileum, is separated with its vessels intact. The remaining bowel is joined back together, so digestion carries on much as before.
Who it is usually offered to
Almost anyone fit enough for a cystectomy can have a conduit. It is the usual choice when the cancer sits near the urethra, when the kidneys are not strong, when hands or eyesight are poor, or when a person wants the shortest operation and the least to learn afterwards.
In the operating theatre
How the conduit is made during the operation
A length of bowel is set aside
After the bladder is out, the surgeon picks a segment of small bowel and separates it, keeping the blood vessels that feed it. The two remaining bowel ends are stitched or stapled back together.
The ureters are joined to it
The two tubes from the kidneys are sewn into one end of the segment. Thin plastic stents are often left inside these joins so they heal open. You may see them poking out of the stoma at first.
The other end becomes the stoma
The open end of the segment is brought out through the wall of the belly, usually on the right, below and to the side of the navel. It is folded back on itself and stitched to the skin, which gives the raised, pink appearance.
The first bag goes on
A clear bag is fitted in theatre so the team can watch the urine and the stoma in the first days. The site is marked on your skin before surgery, sitting and standing, so the bag sits flat under clothes.
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What living with a urostomy actually involves
Most of it becomes routine within a few weeks. The stoma nurse teaches you and one family member before you go home.
Emptying the bag
The bag has a tap at the bottom. You open it over the toilet whenever it is about a third full, several times a day. No touching of the stoma is needed.
Changing the bag
The bag, or its sticky base, is changed every few days or when it starts to lift. The skin is cleaned with plain water and dried, the base is cut to fit the stoma, and the new bag is pressed on.
You will need
- Bags and bases, kept dry and cool
- A measuring guide for the stoma
- Small scissors and a mirror
Nights
A larger drainage bag connects to the day bag at bedtime and hangs by the bed, so you sleep through without waking to empty. Many people find this the easiest part.
The skin around it
Healthy skin under the base should look like the skin next to it. Redness, soreness or a base that keeps lifting usually means the hole is cut too large or the stoma has changed size.
!
Three things that cannot wait
A fever with shivering, especially with pain in the back or side, can mean infection has reached a kidney. No urine in the bag for several hours when you have been drinking normally can mean a blockage. And a stoma that has turned dark purple or black is losing its blood supply. Any of these, go to the nearest emergency department the same day and say you have a urostomy. Do not wait to see if it settles.
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On your report
Words you will see, in plain language
- Stoma
- The opening on the belly. It is pink and moist like the inside of the mouth, and it has no nerve endings, so it does not hurt to touch.
- Urostomy
- A stoma that carries urine. The word is used for the conduit, the opening and the bag together.
- Ureteric stent
- A thin plastic tube left inside each join between ureter and conduit while it heals. Removed at a clinic visit, without an anaesthetic.
- Mucus
- Bowel lining makes mucus, and it will. Cloudy threads in the urine are normal with a conduit and are not a sign of infection on their own.
Commonly believed
Four things families tell us, and what is actually true
"Everyone will be able to smell it."
A sealed urostomy bag does not smell. Smell escapes only when the bag is being emptied or when the seal has lifted, and both are quick to fix. A strong smell with cloudy urine is more likely an infection and worth a phone call.
"He cannot bathe or go to the temple with it."
You can bathe, shower and swim with the bag on. Water does not harm the stoma. People with urostomies work in fields, ride two-wheelers, travel by train and fast during festivals, with a little planning around drinking water.
"The bag means the cancer was very advanced."
The choice of a conduit says nothing about the stage of the cancer. It is chosen for kidney results, the position of the tumour, age, eyesight, hands and preference. Many people with early disease choose it because it is the simplest to live with.
"Bags are hard to find outside Hyderabad."
Supplies can be ordered by courier to any district, and stoma clinics keep a list of suppliers. The real risk is running out during a festival week, so keep a month in hand.
Being straight with you
Who a conduit does not suit, and what this page cannot tell you
A conduit is possible for almost everyone, but it is not always the right answer. Someone who is young, has strong kidneys, a cancer well away from the urethra and a strong wish to avoid a bag may be better served by a neobladder. Someone with severe skin disease on the belly needs a longer conversation with the stoma nurse first.
What this page cannot tell you
It cannot tell you whether a conduit is the right diversion for you. That depends on your scans, your kidney blood tests, your bowel history and how you live. Only your surgical team can weigh those together.
It cannot tell you what the supplies will cost
The bags and bases are an ongoing expense for life. Aarogyasri, CGHS, ECHS, EHS and cashless insurers each have their own rules on supplies after discharge. Ask the billing team to cost a year of supplies against your own cover.
What to do next
Ask to meet the stoma nurse before the operation and to see a real bag. Ask where the stoma will be placed. Bring the person who will help at home.
If you already have a urostomy and something about it worries you, call the helpline.Questions we are asked
Common questions about an ileal conduit
Will the stoma hurt?
No. The stoma itself has no nerve endings, so touching it, cleaning it or fitting a bag over it does not hurt. The operation wound will be sore for some weeks, as after any major surgery, and that is what the pain medicines are for. Pain at the stoma itself is unusual and worth reporting.
Can I drink water normally, and how much?
Yes, and drinking well matters more than before, because it keeps urine flowing through the conduit and washes the mucus out. Your team will tell you what a good daily amount looks like for you. Pale urine in the bag means you are drinking enough.
Will I be able to wear a saree or a dhoti?
Yes. The stoma site is usually chosen below the waistline and away from skin folds, and the bag lies flat when emptied. Tell the stoma nurse before surgery how you tie your saree or dhoti so the site is marked to suit it, not the other way round.
Why are there threads of white mucus in the urine?
Because the conduit is made of bowel, and bowel lining makes mucus. Cloudy threads are expected and are not an infection by themselves. Drinking well thins it. Mucus with a fever, strong smell or back pain is different, and needs a call the same day.
Can I sleep on my side or on my stomach?
On your side, yes, once the wound allows. The night drainage bag hangs from the bed frame so it does not pull. Lying on your stomach is usually uncomfortable with a bag and most people stop doing it. The stoma is not harmed by pressure.
Is the stoma permanent?
Yes. Once the bladder has been removed, the conduit is the route urine takes for life. Changing to a neobladder later is a second major operation and is rarely done. This is why the choice of diversion deserves time before the first operation.
Can I travel or go back to work?
Most people return to work once the wound has healed and their energy is back. Travel is straightforward with a spare bag in your pocket, and long bus journeys are easier with the night bag, which holds more. Heavy lifting needs care in the first months.
Who do I call if the bag keeps leaking?
The stoma nurse. Persistent leaking almost always has a mechanical cause: a hole cut too large, a stoma that has shrunk since discharge, a skin crease under the base, or a bag type that does not suit your shape. It is fixed by refitting.
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Sources
- Macmillan Cancer Support — Bladder cancer
- NHS — Bladder cancer: treatment
- Cancer Research UK — Bladder cancer: treatment
- American Cancer Society — Bladder cancer surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Urinary Diversion: The Three OptionsThe conduit alongside the two no-bag optionsChanging a Urostomy Bag: Step by StepThe routine, in order, for homeSkin Problems Around a UrostomyWhat redness and lifting mean and how to fix themUrostomy Supplies in Hyderabad and What They CostWhere to buy bags and what schemes payLife With a Urostomy BagWork, travel, clothing and confidence
Talk to us
Facing a cystectomy and want to see what a urostomy really looks like?
Call the helpline or send us your letter. A surgical oncologist and a stoma nurse will talk you and your family through it before anything is decided. One helpline serves every CION centre.