Urinary diversion is performed on a regular basis in urological practice. Surgeons and general
practitioners are not always aware of the metabolic effects of any type of diversion. From the
patient’s perspective, diarrhea is the most bothersome complaint after urinary diversion. Rarely,
this is accompanied by other malabsorption syndromes. Hyperchloremic metabolic acidosis is
the “baseline” metabolic state of diverted patients. Other electrolyte disturbances are infrequent.
Partly due to the acidotic state, bone health is at risk in patients with urinary diversion. Many
patients are also subject to urinary calculus formation, both at the upper and lower urinary
tract. The kidney function has to be monitored prior to, and lifelong after, urinary diversion
and screening for reversible causes of renal deterioration is an integral part of the follow up.