A urostomy is done by surgically creating an opening, or stoma, in the abdomen to divert urine from the bladder into an external bag. Urostomies are usually installed when the bladder is no longer functioning as it should be, or in cases of bladder cancer, trauma, infection, reproductive diseases, and birth defects. Urostomies are a must for those patients having a cystectomy, or the removal of the urinary bladder.
The benefits of a urostomy include allowing the urine to be collected and disposed of in an easy, clean way. Ostomies also improve the overall quality of life by preventing constant urine leakage and discomfort. For many people experiencing significant bladder problems or incontinence, a urostomy provides a permanent solution to bladder dysfunction.
The risks from having a urostomy are common infection, bleeding, stoma leaks and issues, hernia, and skin irritation.
Types of Urostomies
The most common type of urostomy done is the ileal conduit, although other types of urostomy may be placed for various medical happenings.
- Ileal conduit. This procedure uses pieces of the small intestine to make a tube that will connect to the stoma. Your ureters will be connected to the newly created tube, and will flow through the tube to the stoma, and then into your urostomy bag.
- Colonic conduit. Like an ileal conduit, but different because tissue from the sigmoid colon is used to create the tube.
- Continent Urostomies: For some, a new bladder must be created, or a reservoir inside from intestinal tissues. This is a continent urostomy. The reservoir might attach to the stoma and then you use a tube to drain from.
- The Kock Pouch. The Kock pouch procedure uses the end of the small intestine to make valves, the pouch, and the pocket.
- The Indiana Pouch. This procedure procures large intestine tissues which are made into a pouch and the tissue from the small intestine for the outlet. For the valve, they might use the ileocecal valve, which is located where the small and large intestines meet.
- The Mitrofanoff procedure. This procedure varies by circumstance and surgeon. Some use bladder tissue, some small intestine tissue, and others use the colon to make the pouch, or even a combination of the tissues. To make the outlet, the surgeon might use the appendix, a fallopian tube, or part of a ureter to complete the outlet.
Having a neobladder, which is a type of continent urinary diversion that uses intestinal tissue to make a new bladder, there will be no stoma. The surgeon will attach the neobladder to your urethra, so pee leaves your body in the way that it did before. You will need to schedule bladder empties as you will no longer have any feeling when you need to go to the bathroom.
Care of the Urostomy
A urostomy requires a bag or pouch to always be worn. These bags are odor free, durable, and come with strong, dependable adhesive. It is important to find a bag that fits your stoma, your body shape, and any other needs or preferences you might have for your lifestyle. Urostomy supplies are available at medical suppliers, or DME suppliers, and work with various medical insurance plans.
Care for a urostomy involves:
- Keeping the stoma skin clean and healthy.
- Changing the bag or pouch system regularly helps to maintain skin health.
- Empty the bag when it is 1/3 to 1/2 of the way full.
- Dry the skin well.
- Apply barrier creams or sprays if needed.
- Use a properly sized barrier opening.
- Shave the hair around the stoma if necessary.
Living with a Urostomy
Life with a urostomy might feel complicated at first for some. For others who have struggled with urine leakage and bladder disease, a bag can be a true relief of stress and discomfort.
- Clothing. Typically, regular clothing can be worn and support belts when needed. For some, attaching the bag only when doing your scheduled bladder emptying is possible.
- Work. With certain exceptions for heavy lifting, bending, or jobs that require certain types of restrictive clothing, it may be necessary to adjust your job tasks or find a new job altogether. There are many job options for ostomates, the trouble often comes in finding the right one. Other ostomates might have other underlying conditions and be unable to work or maintain.
- Intimacy & Connection. There are many ways to be intimate and connect with another human that do not involve sexual acts. The mental side effects from having a urostomy installed might take some time to get used to and adjust to. Sexual function is often affected, causing varying levels of sexual dysfunction for both men and women alike. There are many ways to work around these blocks.
- Diet. Suggested fluid intake says urostomates should ingest eight to ten glasses of fluids per day to ensure hydration and to decrease the chances of a kidney infection. For the most part, food can be maintained as it was before the surgery.
- Sleep. If sleeping is a problem and urination occurs at night, check in to the night drainage bag system which is designed to collect and store urine overnight so you can sleep without multiple empties.
- Activities & Travel. When the bag is securely attached, you can participate in most activities, including swimming and water sports. Proceed with caution when participating in heavy body contact sports and wear a guard belt when needed. Travel is not restricted
- Hygiene. Proceed with your normal hygiene routines. Showering and bathing can be done with or without the bag affixed to the body.
Ostomies are life saving procedures that allow people to resume as normal of a routine as possible. Reaching out for support to find a local group or a national group can be done by visiting the UOAA.
Citations:
United Ostomy Association of America
The Vegan Ostomy
Empowering Intimacy
Hollister
Coloplast