Urinary Diversion after Urologic, Gynecologic, and General Surgical Procedures: Approaches, Consequences, and Considerations for Re-Operation

Session Description

Urinary diversion is performed for benign and oncologic procedures in the abdomen and pelvis by urologists, gynecologists, and general surgeons. There exists a variety of considerations with regards to: indications and choice of diversion type (ureterosigmoidostomy, ileal conduit, colon conduit, continent diversion); surgical techniques; consequences; and potential follow-up issues. This course will take a multidisciplinary approach to urinary diversion and address each of these different topic areas (choice of diversion, surgical techniques, and potential outcomes), and will also address the important considerations required when the abdomen requires re-exploration after the different types of urinary diversion.

Moderator: Jay D. Raman, MD, FACS, Hershey, PA

Co-Moderator: Valentine N. Nfonsam, MD, FACS, FASCRS, Tucson, AZ


Session Introduction
Jay D. Raman, MD, FACS, Hershey, PA

Complex Gynecology Affecting the Urinary Tract: Considerations for Surgical Management
Gerald Harkins, MD, Hershey, PA

Urinary and Bowel Diversion in Patients Undergoing Pelvic Exenteration
Kirsten L. Greene, MD, FACS, San Francisco, CA

Contemporary Management of Rectourethral Fistulas
Madhulika G. Varma, MD, FACS, San Francisco, CA

Complexities of Urinary Diversion in the Setting of the Diseased Bowel States
Stefan D. Holubar, MD, Cleveland, OH

Re-operative Surgery for Failed Urinary Diversions
Tracy M. Downs, MD, FACS, Madison, WI

Session Conclusion
Valentine N. Nfonsam, MD, FACS, FASCRS, Tucson, AZ

Sponsored by the Advisory Council for Urology and the Advisory Council for General Surgery

Target Audience

  • Practicing surgeons
  • Residents

Learning Objectives

  • Apply new knowledge and ideas to improve their surgical practice
  • Adapt concepts and quality measures in support of research advancements
  • Enhance the quality of patient care


For questions about the course, please contact elearning@facs.org.

Course summary
Available credit: 
  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 Certificate of Completion
  • 1.50 Self Assessment Credit
Course opens: 
Course expires: 

Disclosure Information

In accordance with the ACCME Accreditation Criteria, the American College of Surgeons must ensure that anyone in a position to control the content of the educational activity (planners and speakers/authors/discussants/moderators) has disclosed all relevant financial relationships with any commercial interest. For additional information, please visit the ACCME website.

The ACCME also requires that ACS manage any reported conflict and eliminate the potential for bias during the educational activity. Any conflicts noted below have been managed to our satisfaction. The disclosure information is intended to identify any commercial relationships and allow learners to form their own judgments. However, if you perceive a bias during a activity, please report it on the evaluation.

(Download the full list of disclosures).

Faculty and Disclosures

Gerald Harkins, MD - Abbvie: Payment: Speaker
Jay D. Raman MD, FACS - Nothing to Disclose
Kirsten L. Greene, MD, FACS - Ambu: Compensation: Consultant; Intuitive: Compensation: PI of study, consultant; Verb: Compensation: Consultant
Madhulika G. Varma MD, FACS - Nothing to Disclose
Sima P. Porten, MD, FACS - Photocure: Compensation: Advisory Board
Stefan D. Holubar MD - Nothing to Disclose
Tracy M. Downs MD, FACS - Nothing to Disclose
Valentine N. Nfonsam MD, FACS, FASCRS - Nothing to Disclose

Program Committee and Disclosures

CHAIR: Henri R. Ford, MD, MHA, FACS, FAAP, FRCSEng(Hon), Miami, FL - Nothing to Disclosure
VICE-CHAIR: David T. Cooke, MD, FACS, Sacramento, CA - Nothing to Disclosure


David C. Borgstrom, MD, FACS, Morgantown, WV - Nothing to Disclosure
Daniel L. Dent, MD, FACS, San Antonio, TX - Nothing to Disclosure
Roger R. Dmochowski, MD, FACS, Nashville, TN - Allergen: Honoraria: Consultant
Cynthia D. Downard, MD, FACS, Louisville, KY - Nothing to Disclosure
Audra A. Duncan, MD, FACS, London, ON - Nothing to Disclosure
Mariam F. Eskander, MD, Boston, MA - Nothing to Disclosure
Paula Ferrada, MD, FACS, Richmond, VA - Nothing to Disclosure
Neil H. Hyman, MD, FACS, Chicago, IL - Nothing to Disclosure
Martin S. Karpeh, Jr., MD, FACS, New York, NY - Nothing to Disclosure
Dennis H. Kraus, MD, FACS, New York, NY - Nothing to Disclosure
Kenneth W. Sharp, MD, FACS, Nashville, TN - Nothing to Disclosure


Daniel M. Herron, MD, FACS, FASBMS, New York, NY - Nothing to Disclosure
Edith Tzeng, MD, FACS, Pittsburgh, PA - Nothing to Disclosure


Barbara Lee Bass, MD, FACS, FRCSEng(Hon), FRCSI(Hon), FCOSECSA(Hon), Houston, TX - Nothing to Disclosure
Quan-Yang Duh, MD, FACS, San Francisco, CA - Nothing to Disclosure
B. J. Hancock, MD, FACS, FRCSC, Winnipeg, MB - Nothing to Disclosure
Ronald V. Maier, MD, FACS, FRCSEd(Hon), Seattle, WA - Nothing to Disclosure

Continuing Medical Education Credit Information


The American College of Surgeons is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

AMA PRA Category 1 Credits™

The American College of Surgeons designates this enduring activity for a maximum of 1.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Of the AMA PRA Category 1 Credits™ listed above, a maximum of 1.5 credits meets the requirements for Self-Assessment.

American College of Surgeons and ACGME Logos

Note: Residents will receive a Certificate of Completion.

Available Credit

  • 1.50 AMA PRA Category 1 Credit™
  • 1.50 Certificate of Completion
  • 1.50 Self Assessment Credit
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This course is available as part of the Clinical Congress 2019 Webcast Packages