Permanent urinary diversion in childhood. Indications and types

Pathologic conditions of childhood requiring permanent urinary diversion range from the rare malignant diseases to neurogenic bladder, as from meningomyelocele. New techniques of self-catheterization and bladder evacuation by electric pumps and devices are being evaluated. At present permanent urinary diversion is the treatment of choice, and this should be performed before upper tract deterioration occurs. A temporary urinary diversion, loop cutaneous ureterostomy, should be done in patients where eventual reconstruction of the urinary tract is feasible. Types of permanent urinary diversions and indications for each are discussed.