Single-Stoma Cutaneous Ureterostomy After Radical Cystectomy: A Contemporary Narrative Review.

Radical cystectomy (RC) with urinary diversion (UD) is the standard treatment for muscle-invasive bladder cancer. Although the ileal conduit (IC) is the most commonly performed diversion, its reliance on bowel reconstruction leads to substantial perioperative morbidity and long-term complications. Cutaneous ureterostomy (CU) has re-emerged as an attractive alternative, particularly for elderly and medically frail patients, due to its technical simplicity and avoidance of intestinal manipulation. Recent single-stoma and tubeless modifications have aimed to overcome historical limitations of CU, including stomal stenosis and long-term stent dependence. Compared with IC, modern refinements of single-stoma CU showed shorter operative times and generally shorter hospital stays, largely reflecting avoidance of bowel reconstruction. Estimated blood loss and overall intraoperative complication rates were broadly comparable between diversion types. Contemporary retrospective data on single-stoma modifications showed lower rates of stomal stenosis and improved catheter-free outcomes compared with historical data, while infectious complications and readmission rates remained similar to those of IC in most series. Renal outcomes generally remained stable, with patient factors such as baseline renal function, hydronephrosis, and stent dependence appearing to be more influential for long-term deterioration than diversion type alone. Quality of life after contemporary single-stoma CU was similar to IC, based on the available retrospective evidence. Overall, contemporary single-stoma CU represents a valuable bowel-sparing urinary diversion that may potentially reduce operative burden while maintaining acceptable functional and quality-of-life outcomes. Current retrospective evidence supports its role as a particularly attractive option for elderly and frail patients, although prospective, multicenter comparative studies with standardized outcome reporting are still needed to better define patient selection and long-term outcomes.