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Urostomy

Thumbnail image of: Urinary System: Illustration
Thumbnail image of: Urostomy: Illustration

Urostomy

What is a urostomy?

A urostomy is an opening, called a stoma, made in your belly that is done so your urine can pass out of your body. A urostomy is needed when your bladder doesn’t work well or needs to be removed.

There are 2 types of urostomy:

  • Standard or conventional urostomy: The urine is collected in a pouch, called an ostomy bag, attached to the opening outside of your belly. The bag can be emptied when it fills up.
  • Continent urostomy: Your healthcare provider makes a pouch to collect urine inside your body. The pouch is drained through the stoma several times a day with a flexible tube called a catheter.

Your healthcare provider will talk to you about which type of urostomy would be best for you.

When is it used?

You may need a urostomy if you have bladder problems such as:

  • Bladder cancer
  • Damage to your bladder from a birth defect, chronic infection, scarring, or nerve damage

How do I prepare for this procedure?

  • Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover. You may want to have family members learn about your care so they can help you at first and give you support and encouragement. This body-changing procedure can affect people in different ways. Understanding how to care for the stoma is the first step toward helping you deal with your concerns.
  • Follow your provider’s instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It’s best to quit 6 to 8 weeks before surgery.
  • If you are going to have a standard urostomy, you may have a bag put on your belly several days before surgery to find the best spot for the opening.
  • You may or may not need to take your regular medicines the day of the procedure. Tell your healthcare provider about all medicines and supplements that you take. Some products may increase your risk of side effects. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
  • Your healthcare provider may prescribe antibiotics for you to take a few days before and after surgery to help prevent infection.
  • Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
  • Your healthcare provider may ask you to take an enema or medicine to clean out your bowel before surgery.
  • Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
  • Follow any other instructions your healthcare provider gives you.
  • Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for any tests or procedures.

What happens during the procedure?

This procedure is done at the hospital.

You will be given a general anesthetic before the procedure to keep you from feeling pain. General anesthesia relaxes your muscles and you will be asleep. Your healthcare provider will make a cut (incision) in the lower part of your belly.

  • If you have a standard urostomy, your provider will cut the tubes that drain urine from the kidneys into the bladder. A piece of your intestine will be cut out and used as a tube to drain the urine from your kidneys through an opening in your skin. Because the urine will drain all of the time, you will have to have a bag attached to the outside of your belly to collect the urine.
  • For a continent urostomy, your healthcare provider will make a pouch inside your body with a piece of intestine or bladder. Urine will collect in this internal pouch. It will be drained using a flexible tube called a catheter. You will need to put the catheter into the pouch several times a day to drain it. You will not need to wear an ostomy bag to collect urine.

What happens after the procedure?

Usually you will stay in the hospital for 5 to 7 days, depending on your condition.

After surgery you will be given intravenous (IV) fluids. You may need pain medicine for the first few days after surgery. You will only be able to drink small amounts of clear liquid right after the surgery. You will then slowly start eating regular food.

At first, your stoma care and bag or pouch emptying will be done by nurses or a stoma therapist. You will learn how to clean and care for the stoma, empty and change bags or drain the pouch inside your belly before you go home.

Ask your healthcare provider:

  • How and when you will hear your test results
  • How long it will take to recover
  • If there are activities you should avoid and when you can return to your normal activities
  • How to take care of yourself at home
  • What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

Also ask your provider about any changes you should make in your normal lifestyle (including sexual activity). For example, if you have an ostomy bag:

  • Preventing odor by cleaning the bag well and using a bag deodorant
  • Using a room deodorizer if necessary
  • Emptying the bag when it begins to fill to prevent leaking around the seal
  • Not wearing tight clothing over the stoma and bag

What are the risks of this procedure?

Your healthcare provider will explain the procedure and any risks. Some possible risks include:

  • You may have problems with anesthesia.
  • You may have infection, bleeding, or blood clots.
  • Other parts of your body may be injured during the surgery.
  • Scar tissue may form in your belly and cause a blockage in the bowel.
  • Your bowel function may change. You may have frequent bowel movements or diarrhea.

Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.

For more information, contact:

Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth.
Last modified: 2014-12-08
Last reviewed: 2014-12-08
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

Urostomy: References

Burch, J. (2014). Stoma care in the community.. Br J Community Nurs.19(8):396, 398, 400.

Elshal, AM, Abdelhalim, A, Hafez, AT, Abol-Enein, H. (2012). Ileal urinary reservoir in pediatric population: objective assessment of long-term sequelae with time-to-event analysis. Urology;79(5):1126-31.

Gomez, A, Barbera, S, Lombraña, M, Izquierdo, L, Baños, C. (2014). Health-related quality of life in patients with urostomies. J Wound Ostomy Continence Nurs;41(3):254-6.

Nazarko, L. (2014). Urostomy management in the community.Br J Community Nurs;19(9):448-52.

Peters, KM, Jaeger, C, Killinger, KA, Rosenberg, B, Boura, JA. (2013). Cystectomy for ulcerative interstitial cystitis: sequelae and patients’ perceptions of improvement. Urology;82(4):829-33.

Schultz, A, Boye, B, Jonsson, O, Thind, P, MÃ¥nsson, W. (2014). Urostomy and health-related quality of life in patients with lower urinary tract dysfunction. Scand J Urol. 2014 Nov 5:1-6.

Thorstenson, A, Jacobsson, H, Onelöv, E, Holst, JJ, Hellström, PM, Kinn, AC (2007). Gastrointestinal function and metabolic control after construction of an orthotopic ileal neobladder in bladder cancer. .

Scand J Urol Nephrol;41(1):14-9.

Vyas, P, Crispen, PL. (2014). Metabolic bone disease following urinary diversion in adults. Curr Opin Urol;24(6):614-8.

Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

Copyright ©1986-2015 McKesson Corporation and/or one of its subsidiaries. All rights reserved.

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