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Further Reading - Urostomy

• What is a Urostomy?
• Changing Your Appliance
• Dietary Advice
• Problems + Solutions

What is a urostomy?

To help you understand what is involved in the operation, you may wish to first look at the Urinary System and how it works.

Definition of a Urostomy

"A surgically created opening on the abdominal wall to which part of your bowel, i.e., colon is attached, also known as a stoma."

Stoma is a Greek word meaning mouth or opening. A urostomy can be temporary or permanent, dependant on the reason for the surgery. It is normally red in colour, similar to the inside of your mouth, and bleeds easily if handled roughly. Round or oval in shape, it has no nerve supply or muscles, therefore, it cannot be voluntarily controlled. How a urostomy is created

A Urostomy is usually created when urine needs to be diverted away from the bladder and a new exit route formed to the outside of the body.

To achieve this a section of the small intestine is removed and used to create a tube which leads from inside the body to the surface of the skin on the abdomen. Where this section of intestine has been removed the two ends of intestine are joined back together allowing your bowel to function as normal.

The ureters which come from the kidneys are separated from the bladder and joined to the tube of small intestine so that urine flowing from the kidneys will pass down them into the intestine tube and out of the body.

The open end of small intestine on the surface of your abdomen is usually formed as a small spout. This is most frequently positioned to the right of your navel below the waist line, and is normally pinkish red in colour, similar to the inside of your mouth. This visible part is the stoma and this particular stoma is called a urostomy or sometimes referred to as an ileal conduit.

Why a urostomy?

There are a variety of reasons why a urostomy may be necessary, all of which are concerned with a defect or problem with the urinary system which needs to be removed or bypassed.

Babies are sometimes born with a defect of their urinary systems. In adults there may be nerve damage or incontinence, other problems may occur as a result of disease, for example, multiple sclerosis or tumours of the bladder.

Changing Your Appliance Urostomy

How frequently you change your ostomy appliance will depend on you and the type of pouch you use. As a rough guide: These are only guidelines and you will eventually establish your own routine. If the appliance leaks it should be changed immediately to prevent your skin from becoming irritated. For advice on preventing leaks see Problems Which May Arise and How to Deal With Them.

1. Preparation

Before changing your appliance, ensure that you have all of your equipment prepared. You may find it handy to keep a small supply in a container in the bathroom (e.g. an old plastic ice-cream tub). You will need:

• A clean appliance plus any accessories (i.e. paste, skin protective wipes if used etc).
• Warm water - do not use disinfectant or a perfumed soap - special ostomy soap is available.
• Wipes (kitchen roll is a good substitute, but cotton wool and tissues are not generally advised).
• Disposable plastic bag.
• Scissors and template if required.

2. Changing

• Secure clothing out of the way (clothes pegs or large safety pins may help).
• Empty your appliance down the toilet as directed.
• Remove appliance carefully working from the top down, supporting the skin. Place it in disposable bag.
• Clean skin and stoma with warm water and wipes. It may help to use a dry wipe first to remove any residue and mucous from the base of the stoma. Use wet wipes to wash the stoma and skin (NOTE: any soap used (e.g., ostomy soap) must be washed off before drying). Dry skin thoroughly with a dry wipe. Do not worry if your stoma bleeds slightly when washed. This is normal. If blood comes from inside your stoma you should seek the advice of your GP or Stoma Care Nurse.
• Apply skin protection as required. If using alcohol type wipes ensure that the skin has dried before proceeding. Do not use any creams, ointments or powders of your own which have not been recommended by your Stoma Care Nurse.
• Remove appliance backing paper. Put into position carefully and slowly (it may be easier to do this standing upright). A mirror may help you to see your stoma. Ensure that once in place the flange is smooth and stuck firmly to the skin, paying particular attention to the base. When using 2-piece products then apply pouch to flange.

3. Disposal

If your appliance is full, empty contents down the toilet.

• Do not put pouch down the toilet unless it is specifically designed for this purpose.
• Place SOILED APPLIANCES AND WIPES in disposal bag and secure.
• Place in dustbin. Do not flush down the toilet or burn on an open fire.
• Tidy up and wash hands.
• Re-stock container with all equipment to ensure that you are always prepared.

Dietary Advice Urostomy

There is no special diet to follow, just eat a normal well balanced diet.

You should however drink plenty of fluids as this helps to reduce the risk of urine infections.

You can also drink alcohol, but remember that just as your bladder did, your pouch will fill more quickly.

Problems + Solutions Urostomy

Cloudy and Strong Smelling Urine
This is usually a sign that you have a urine infection. Increase your fluid intake and consult your Doctor.

Bleeding
If you are too rough when cleaning your stoma slight bleeding can occur. This is nothing to be concerned about, just be a little more gentle. Bleeding can also be caused by friction from an ill-fitting appliance, to help reduce this see Stoma Paste, Cohesive and Salts Medilink's Cut-to-Fit Service. You may need to re-measure your stoma and change the size of your pouch. Your Stoma Care Nurse will be able to help you. If there is blood in the contents of the pouch, consult your Doctor.

Sore Skin Around the Stoma
There are a number of causes of sore skin and different ways to deal with it:

• Too frequent pouch changes: - try using a two-piece appliance
• Allergy to pouch adhesive: - either try an alternative pouch or use skin protectors such as Protective Wafers or Protective Wipes
• Leakage of faeces onto the skin: - this can make the skin very sore and can be the result of an ill-fitting pouch. Your stoma may have changed size, so measure it and check you are using the correct size appliance. If you have uneven skin around your stoma, e.g., scarring or creases, you can use a seal/washer or a paste to create a smooth surface to apply your pouch to. This often prevents leaks.
• Infection due to body hair growth under the adhesive: - shave the area carefully as required.
• Sore skin may also be caused by pre-existing skin allergies or by food and drink allergies. Always consult your Stoma Care Nurse and Doctor if you have any persistant problems.

 

 

 

 

 

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