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Urostomy is a type of urinary diversion, which requires a pouch to be worn outside the body. A urinary diversion may be necessary if a person cannot urinate because a part or parts of the urinary tract is damaged or not working properly. A doctor may recommend urinary diversion if:

 A person’s bladder has been removed to stop or prevent spread of cancer

 A person’s bladder has nerve damage

How is urostomy done?

In urostomy the surgeon creates an opening, called stoma (Illustration on the right), in the abdomen where urine is directed. There are two main types of urostomy., ileal conduit and ureterostomy.

Ileal conduit

In this type of urostomy, the surgeon takes a short segment of the small intestine. The remaining intestine is reconnected so that it functions normally. One end of the removed short segment of intestine is placed at the skin surface to create a stoma. The other end of the removed intestine is attached to the ureters—the two tubes that normally carry urine from the kidneys to the bladder.

Urine formed in the kidneys travel through the newly formed passageway, out of the stoma and into the external collecting pouch. The pouch has an outlet where urine can be released into a toilet without removing it from the stoma. (See illustration on the right)

Ureterostomy

In ureterostomy, a surgeon connects the ureters directly to the abdominal wall to create a stoma. This procedure, however, is rarely performed.

Just like the ileal conduit, a ureterostomy requires a pouch placed over the stoma, which collects the urine.

Caring for your urostomy

After the surgical procedure, your WOC nurse can work with you to help you learn how to take care of your urinary diversion. WOC stands for wound, ostomy, and continence. If you have any concerns about your urinary diversion, don’t be shy to ask your WOC nurse because they are experienced and knowledgeable regarding this matter.

Changing pouches

Your doctor or WOC nurse can work with you on how to properly change your pouch. The pouching system usually consists of two pieces—a barrier and a collecting pouch.

The barrier sticks to your skin and prevents urine from leaking making sure that urine flows to the collecting pouch. The collecting pouch collects the urine that comes out of the stoma. In some pouching systems, the barrier and pouch are a single unit.

Cleaning

You can clean your skin with wet towelette or washcloth as you change your pouch making sure that the skin is completely dry before applying the new pouch. Sometimes, the skin surrounding the stoma gets irritated. When this happens, you can use protective skin wipes or an ostomy powder, which is specifically designed to protect the skin around the stoma.

How to recognize infection

Urostomies can get infected. Some of the signs and symptoms of infection include

 Dark urine or urine containing excess mucus

 Foul odor or strong-smelling urine

 Pain in the back

 Nausea

 Vomiting

 Poor appetite

Inform your health care provider if you notice any of these warning signs. To help prevent infection, your doctor may recommend that you drink eight full glasses of water every day to help flush out bacteria.

Diet

You may not need any dietary restrictions. You can probably be able to eat your normal diet. Some foods can cause urine to have a stronger odor, such as asparagus and seafood. Your doctor or dietician can help you plan a better diet.

Clothing

You may not need any special clothing if you have undergone urostomy. However, tight clothing may not be advisable to be worn. Most modern pouches are designed to lie flat against the body so they can’t be noticed.

Activities

You will probably be advised by your doctor to limit your activities during the first few weeks after surgery. This will allow enough healing of the wound. After it has healed, you can perform most of your normal activities. However, full contact sports, such as football or karate should be avoided. You may also want to talk to your employer regarding changes in your job responsibilities.

References:

National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC). Urostomy and Continent Urinary Diversion. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH). NIH Publication No. 06–5629, May 2006

Tortora, G. and Grabowski, S.: PRINCIPLES OF ANATOMY AND PHYSIOLOGY. 10th ed. John Wiley and Sons, Inc., 2003.

Seeley, R., Stephens, T., and Tate, P.: Essentials of Anatomy and Physiology.5th ed.Mc-Graw-Hills, Inc., 2005

Image Credit: NIDDK Image Library

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