A urostomy is the removal of the bladder and creation of a surgical opening, or stoma, to allow urine to drain. It is a method of treatment for bladder cancer, and doctors also might perform it to correct a birth defect or a chronic bladder infection. Rather than controlled urination, a urostomy patient's urine will flow naturally out of the body and into collection pouches. The stoma and pouches will require some adjustment, but urostomy care eventually can become as natural a part of a hygiene routine as washing hair or shaving.
Pouches
Pouching systems collect the urine for urostomy patients and come in either one- or two-piece bags, depending on a patient's needs. Proper care of the pouch requires regular drainage and changing. Drain the pouch when it is between 1/3 and 1/2 full. This will be about every 2 to 4 hours, or more often when drinking a lot of fluids. To drain, open the pouch's valve and empty the urine directly into the toilet. Change the pouch every 3 to 7 days or immediately if there is leakage. Find the position that best allows you to see your stoma. This might be lying down or standing up and might require a mirror. Remove the old pouch, wash the stoma and apply the new pouch, putting the sticky side to the skin and pressing down to seal all edges. It might take some practice, but this ultimately can be done in 10 minutes or less.
Stoma Care
The stoma needs regular cleaning to prevent irritation caused by regular contact with urine, which has a high bacteria count. A wipe with a wet cloth while changing the bag will usually be enough. Soap is safe, but make sure to rinse well afterward. Avoid using oily soaps around the stoma. Use skin wipes or powders to protect the skin around the stoma further and under the pouch barrier. Dry the stoma area well before applying pouches. Spots of blood around the stoma are not uncommon due to its delicate blood vessels. Any bleeding will usually stop quickly.
Complications
The most common complication following a urostomy is irritation of the stoma or the skin around it. Treat mild irritation, when the skin is red and itchy, by washing the stoma and applying and blotting off ostomy protective powder. Seek medical attention if the irritation worsens or does not clear up. Also, see a doctor if the stoma changes size or color, bleeds heavily or if you spot blood in the pouches during several draining times. A strong odor from the urine might indicate a kidney infection, so also check with your doctor if that occurs.
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