Let's learn about urostomies

Let's learn about urostomies

What is a urostomy?

A urostomy or ileal conduit is the most common type of non-continent urinary diversion operation. During the operation, a surgeon will make a hole in your abdominal wall. This hole is known as a urinary stoma. An ileal conduit is formed by detaching the ureters from the bladder and joining them onto a short length of the small bowel (ileum). One end of this length of the ileum is sealed off and the other is brought to the surface, pulled through the hole in your abdomen- slightly protruding, to form the urinary stoma. This system allows urine to drain directly from your kidneys, down to the conduit and out into an external collecting system called a stoma appliance or bag which you wear on your abdomen over the stoma. Urine will drain out of this stoma continually. 

How a urostomy is made

The surgeon makes the urostomy during the operationto remove the bladder. To make a urostomy they:

  • remove a section of the small bowel called the ileum
  • join the end of this to the two tubes called ureters from your kidney
  • bring the other open end of the section of bowel out through a small opening in the skin of the tummy. The opening is called a stoma.

Before the operation, the surgeon or stoma nurse will talk to you about the best position for your stoma. After the operation you will not pass urine in the same way as before. Instead urine flows from your kidneys through the ureters and the piece of bowel and out of your body through the stoma. You wear a bag over the stoma to collect the urine. The stoma should be easy for you to reach to empty or change the bag.

What is a urostomy bag

A urostomy bag is a flat, watertight bag that you wear over the stoma to collect urine (pee). The bag has a sticky back which can stay in place for several days without needing to be changed. It also has a small tap or valve at the lower end so you can empty the bag into a toilet when needed. There are different brands and types of urostomy bags. These are available free on prescription. Your stoma nurse can give advice about which types might work best for you. 

After surgery

The urostomy stoma will be bruised and swollen at first. But it will shrink to it's final size within a few weeks. At first, it is not unusual for the stoma to bleed slightly when cleaned. Your nurse will tell you more about this. The stoma will also produce mucus, this is a thick, white liquid. It might appear as pale threads in the urine (pee). As soon as you feel ready, your nurse will show you how to clean your stoma and change the bag. You may want a family member or friend with you while you are taught to take care of your stoma, this means they will know how to help you at home, if needed. 

How to empty a urostomy bag

A urostomy produces urine (pee) steadily through the day. Most people get into their own routine of when and how often the bag fills up and needs to be emptied. To empty a urostomy bag, you will need to:

  • Get into a comfortable position that lets you aim the urostomy bag tap or valve into the toilet. Some people stand or kneel, others prefer to sit on the toilet. 
  • Open the tap or valve at the lower end of the urostomy bag and let the urine empty into the toilet. 
  • Dry the tap with toilet paper and make sure it is closed

At night, you can attach a larger bag to the tap at thr bottom of your urostomy bag. Overnight urostomy drainage bags collect more urine so you do not need to empty them until the morning. Put empty used urostomy bags in a sealed bag and dispose of them in your household rubbish. 

Changing a urostomy bag

Before you change your bag, make sure that you have everthing you need. It is a good idea to keep everything you need in one place. This means you do not have to search for things at the last minute. Give yourself plenty of time so you can work at your own pace without any interruptions. Wash your hands before and after to help prevent infections. Your stoma nurse will give you advice about the following:

  • How often to change your urostom bag- some types are made to stay for several days, but it can vary.
  • Urostomy stoma care- when you change the bag it is important to clean the stoma and nearby skin carefully. Your stoma may bleed a little when you clean it. This is normal, but tell your stoma nurse if you have sore areas around the stoma or notice blood coming out of the stoma hole.
  • How to fit a new bag- the bag should fit closely around the stoma to keep urine away from your skin and prevent soreness. tell your stoma nurse if you find the type of urostomy bag you have difficult to use, they can give you advice or may suggest another type of bag. 




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