Urostomy Information

Urostomy

A urostomy is the least common of the three main types of stoma. It is sometimes referred to as an ileal conduit because of the way it is fashioned using a piece of small bowel.

Surgery involves removing the bladder (cystectomy) or bypassing the bladder (urinary diversion). Resulting in the urine formed in the kidneys passing down the ureters into an isolated segment of small bowel, which acts as a tube to the body’s abdomen.

A piece of small bowel about 15cm long is isolated with its blood supply; the remaining small bowel (ileum) is then joined back together. The ureters are separated from the bladder and joined to the isolated piece of small bowel. One end of the small bowel is then brought out onto the surface of the abdomen and a spout is formed.

Ureteric stents – inserted via the stoma at the time of surgery – are used to maintain patency of the ureters and are removed 7–14 days post-op. They should be removed only on the advice of the Urologist, and usually after a specific X-ray procedure to check patency.

A urostomy is generally sited on the right-hand side of the abdomen and ideally has a spout of approximately 25-35mm. This should be pink in colour and moist. The urostomy has very little or no sensation and will reduce in shape and size between 6–8 weeks after formation. So it is important, to regularly remeasure the shape and size and alter the template to ensure that a snug fit is maintained.

The urine is usually straw coloured but strands of mucus may be visible.

Urostomy Products

An individual may wear either a one-piece or two-piece product, depending on their lifestyle and personal preferences. Urostomy pouches all have a tap, and people living with a stoma should be encouraged to empty their pouch before the product is half-full. There is also a non-return valve inside the pouch, which prevents urine from washing back up around the stoma, when sitting or lying down. It is good practice for a night drainage bag to be connected during the night to prevent a large build up of urine, whilst sleeping and increasing the risk of the stoma pouch leaking. This option is often a personal choice however.

If a urostomist chooses to wear a one-piece pouch, they will usually change every 1-3 days. However if they have chosen a two-piece pouch this allows for the pouch to be changed at different times to the flange wafer, allowing the user more flexibility and personal choice over their stoma care routine.