Canadian Urinary Diversion Position Statement:
Collaboration of Canadian Urological Association, Nurses Specialized in Wound, Ostomy and Continence Canada, and Urology Nurses of Canada

January 2022

The purpose of this national position statement is to support health care professionals, including surgeons, nurse specialized in wound, ostomy, and continence (NSWOC) and urology nurses with the delivery of standardized clinical best practices for the pre- and postoperative care management of patients undergoing a urinary diversion. Through this position statement, we have the opportunity to reinforce the fundamental principles enabling health care practitioners to educate and counsel patients on the various urinary diversion options.


Preoperative Stoma Site Marking for Fecal Diversions: Ileostomy and Colostomy:
Position Statement of the Canadian Society of Colon and Rectal Surgeons (CSCRS) and the Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC).

March 2020

This position statement marks a collaborative project between the Canadian Society of Colon and Rectal Surgeons (CSCRS) and the Nurses Specialized in Wound, Ostomy and Continence Canada (NSWOCC).

NSWOCC grants permission for you to make copies of this enabler of practice. Users of this enabler of practice must ensure they have first familiarized themselves with the full position statement.

The NSWOCC would like to thank the 5 Colon and Rectal Surgeons and 12 NSWOCs from across Canada who dedicated time and effort over the past year in completing this project.

Each year a projected 10,000 Canadians have colorectal surgery to create an ostomy. Widely adopted complication rates in the literature suggest that 21-70% of these will result in complications.  Obesity, emergency surgery, diabetes and preoperative stoma site marking have been demonstrated to have the most significant impact on complication rates.  Stoma site marking has a preventative role.

The purpose of this position statement is to guide surgeons and NSWOCs in the effective placement of fecal stomas for patients undergoing ostomy surgery and to improve patient outcomes through reduced postoperative complications. The location of the stoma is a crucial factor in preventing problems. Stoma complications often result in an extended hospital stay and longer recovery for the patient, at an already stressful time.

The evidence is clear; preoperative marking of the patient by qualified personnel for ideal stoma site placement reduces the risk of early complications and leads to higher health-related quality of life. A more informed patient involved in comprehending the impact of the stoma and its care will lead to a better quality of life after discharge.

The body of literature is emphatic that preoperative site marking should be mandatory in elective cases. This position statement reinforces the necessity to have NSWOC and surgeons available at all times for emergency case interventions for stoma site marking.