What is Urostomy?
Urostomy is an opening created in the abdomen by the surgeon during surgery. It helps by allowing the urine to bypass the injured or impaired bladder and exit the body. It works by directing the urine away from the bladder and allowing it to pass out of the body, through an opening created by the surgeon known as a stoma.(1)
Urostomy is the most common surgery of the bladder.(2)
Urostomy is needed by a person who has bladder cancer or any other problem affecting the bladder. The other conditions include:
- Spinal cord injury
- Birth defects which may include spina bifida or bladder exstrophy
- Damage to the nerves
- Chronic inflammation of the bladder
How is a Person Prepared for Urostomy?
Before surgery, tests are performed to make sure a person is healthy for the procedure ahead. The tests may include blood tests, an electrocardiogram, and a chest x-ray.
An appointment is arranged with a surgeon and ostomy nurse who locate the spot to place the stoma. The area needs to be flat and easy to reach by the person. The individual is explained how to use the ostomy pouch.
The doctor instructs, to stop using any blood thinning medication a week before the surgery. Quitting smoking before urostomy may be recommended as it may be helpful in early recovery.
A person is asked to go on a liquid diet a week before the surgery and is asked not to eat anything after midnight. Instructions are given to wash the belly with antibacterial soap, the night before the surgery.
During the Surgery
As a urostomy is an inpatient procedure, a person is asked to stay in the hospital for a few days.
The procedure is performed under general anesthesia. During the procedure, a small piece of the intestine called the ileum is removed and the rest of the intestine is reconnected for normal bowel movements.
The ileum at one end is attached to the ureters, the tubes that travel from the kidneys to the bladder, and the other end of the ileum is attached to the stoma. The urine travels from the ureters through the ileum into the pouch present outside the body.
It is a 3-4 hours surgery and the person is transferred to a special care unit for recovery.
Recovery Period Following Urostomy Surgery
The person needs to stay in the hospital for 4-7 days after surgery. First, a drain is placed to remove fluid from the abdomen. Fluids are not given for a few days post-surgery.
The nurse provides education on how wound care should be done and about the medications. Strenuous activities are asked to be avoided.
Person after reaching home should make sure the wound area is kept clean to avoid infection. The following are the tips that can be helpful in taking care of the wound:
- The area of the incision should be washed with antibacterial soap and kept dry.
- Avoid taking bath until the incision is fully healed.
- The pouch should be changed regularly to avoid irritation or urine leakage.
Side Effects and Complications of Urostomy
Bleeding a little bit around the stoma is normal, but in case of excessive bleeding coming from inside the stoma, a doctor should be consulted.
A person may also have swelling in the genitals and legs. Sometimes there may be draining out of fluid from the penis and vagina post-surgery.
Also, the flow of urine through the stoma may irritate the skin, which may lead to the development of white bumps.
Other risks of urostomy may be:
- Infection
- Blood clots
- Pneumonia
It is important to contact a doctor or an ostomy nurse if:
- there is excessive bleeding from the stoma opening
- soreness of skin or severe skin irritation
- strong odor from the stoma
- fever
- bulge or pain in the abdomen
- bloody or foul-smelling urine
- purple, black or white stoma
- change in the size of the stoma
Outcome of Urostomy
It takes time for a person to adjust to living with an ostomy pouch. An ostomy nurse help with the adjusting process. Most people go back to their normal routine after a urostomy.
A person can also join ostomy support groups to get comfortable with the process.
