Powered By
Continue with Facebook
Continue with Email
Have you been told you need a urostomy? A urostomy is a surgery that creates an opening for urine to leave your body. You may need this surgery when you have a damaged bladder or if you have had a cystectomy (bladder removal) due to bladder cancer.
This article will walk you through how a urostomy works, what to expect, and how to care for it.
Sign up to view the results!
Continue with Facebook
Continue with Email
The bladder is an organ that holds your urine before it leaves your body. Healthcare providers may recommend removing the bladder to treat bladder cancer. Removal of the bladder means you will need a new way for urine to leave your body. This is done via a urostomy.
To make a urostomy, the surgeon:
Urine drains through the stoma into a pouch worn on the outside of the body. This process is called urinary diversion. The pouch may be inside or outside of your body, depending on the type of surgery.
There are two main types of urostomies — incontinent urostomy and continent urostomy. The difference between the two is how they route urine out of your body and whether the urine output can be controlled.
With an incontinent urostomy, there’s no way to control how often urine is drained from your body. A pouch must always be worn to collect the urine.
The most common type of incontinent urostomy is an ileal conduit. It creates a small tube from a part of your small intestine.
One end of the tube is connected to the ureters and the other end is brought to the abdomen to form a stoma. This allows urine to flow through the tube and out of the stoma.
A continent urostomy is done by inserting a catheter (thin, flexible tube) into the stoma.
There are two kinds of continent urostomies. In a neobladder, the internal pouch is connected to your urethra, so you urinate in much the same way as before — no stoma or external bag.
In the other kind, the pouch connects to a stoma and is drained with a catheter. This pouch must then be emptied several times per day.
You can expect the urostomy procedure to last up to six hours. The surgery is done under general anesthesia, and you may need to stay in the hospital for up to 10 days after.
While you are in the hospital, you can expect to:
Your stoma will likely be swollen after surgery. You may also have stents (thin tubes), bruises, or stitches around it. Stents will be removed when you have healed enough.
Your stoma may appear dark at first. As it heals, the bruising and swelling will go away. It may take a few weeks for the stoma to take on its normal color. You may also see some mucus coming out of the stoma. This is normal, as your small intestine makes mucus.
You may be ready to go home once your urostomy is working and you know how to care for it. Your healthcare provider will provide instructions for your recovery at home.
Your healthcare team will teach you how to care for your specific urostomy. Care will vary depending on the type of urostomy. Most types need to be emptied several times a day. A neobladder is emptied by urinating through the urethra rather than draining an external pouch.
An incontinent urostomy is emptied through a drain at the bottom. You should empty the pouch when it’s about one-third or halfway full. If too much urine is in the bag, it can get heavy, which can damage the barrier seal that keeps the pouch in place.
To empty your incontinent urostomy pouch, follow these steps:
Incontinent urostomy pouches need to be changed out often. This will depend on the type of pouching system you have. Some may need to be changed daily while others may last three to seven days.
The time of day you change your pouch will depend on your routine. It may be easiest to change it in the morning before you’ve had anything to eat or drink.
If you change it later in the day, you may want to wait one to two hours after drinking fluids. This can help prevent getting urine on your hands or supplies when you change your pouch.
If you have the catheterizable type of continent urostomy, you’ll drain the internal pouch by inserting a catheter into the stoma. Emptying the pouch with a catheter shouldn’t hurt. A neobladder is emptied differently — by urinating through the urethra.
You can empty the pouch in the bathroom and let the urine drain right into the toilet. You can sit on the toilet, sit facing the toilet, or stand in front of the toilet — whichever way feels best for you.
After surgery, you will need to empty the pouch often because it only holds a small amount of urine. After about four to six weeks, the pouch usually stretches and can hold more urine. Then, you may only need to empty it about three to five times per day, but this may vary for each person.
Your healthcare provider will give you a schedule to follow. The schedule helps keep too much pressure from building up in the pouch and helps the pouch slowly hold more urine. If you feel pressure or fullness, empty the pouch even if it’s not your scheduled time.
Aside from emptying the pouches, you will also need to care for your skin and the stoma. You can protect both by:
It may take time to get used to the changes that come after a urostomy. If you’re struggling to adapt to the changes that come with a urostomy, you can talk to your healthcare provider or find a support group to talk to others who understand what you’re going through.
Here are some things you can expect in your day-to-day life.
You can choose to bathe and shower with or without the pouch on. Although soap and water are not harmful to your stoma, it’s best to use only water while cleaning the skin around it. Using soap or bath oils can make it harder to get a good seal on the pouch.
Having a urostomy doesn’t usually affect the type of clothing you wear. You should be able to wear the same clothing as before surgery. When choosing swimwear it might be helpful to choose dark colors or patterns, if you prefer to hide the pouch system.
To avoid waking up multiple times at night, you can try a night drainage system. These pouches can hold more urine to allow you to sleep longer without having to empty it.
If you experience any of the symptoms below, call your healthcare provider:
On MyBladderCancerTeam, people share their experiences with bladder cancer, get advice, and find support from others who understand.
What was your urostomy recovery like? Let others know in the comments below.
Get updates directly to your inbox.
Continue with Facebook
Continue with Email
Continue with Facebook
Continue with Email
Become a member to get even more
Join
Your Privacy Choices
This is a member-feature!
Sign up for free to view article comments.
We'd love to hear from you! Please share your name and email to post and read comments.
You'll also get the latest articles directly to your inbox.