Everything you need to know about urostomy surgery

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A urostomy is a common surgical procedure in the treatment of bladder cancer. Although this surgery has life-saving benefits, it can also bring many changes in your life.

If you have a urostomy, you can develop new routines that will help you stay healthy and get back to the activities you love.

The bladder is a hollow and flexible organ. Its main function is to store urine and push it out of the body.

When there is cancer in the bladder, a tumor can form. If bladder cancer is not treated, it can spread to other parts of the body.

Surgery is common in the treatment of bladder cancer. Some people can have their entire bladder removed. A surgeon must then create a way to store and pass the urine.

There are a few options:

  • Incontinent diversion: A doctor attaches a piece of intestine to the ureters, which carry urine from the kidneys. This creates an ileal conduit, or pathway, from the kidneys to an opening in the front of the stomach called a stoma. A small bag called a stoma bag attaches to the skin around the stoma to collect urine. In a cutaneous ureterostomy, the ureters are attached directly to the stoma. This procedure is also called a urostomy.
  • Continental deviation: It works the same way as the incontinent bypass, but instead of a bag at the stoma, a surgeon creates a one-way valve. This is emptied several times a day using a tube.
  • Neobladder: It involves creating a new bladder inside the body using a piece of intestine.

After urostomy surgery, you may experience a transition period. Developing a plan to take care of your overall health and changes in your body, such as managing an ostomy bag, can take time. Your healthcare team and personal support system can help.

Most people empty the urostomy pouch as often as they would have used the toilet before surgery or several times a day.

Since bacteria can build up in the bag and a full bag can put pressure on the seal, try emptying the bag when it’s half to one-third full.

You can empty the bag by sitting on the toilet and opening the valve at the bottom of the bag. The contents will flow directly into the toilet. After closing the valve, you can use toilet paper to dry the tip. The paper does not need to be sterile.

Some people use a nighttime drainage system, where a tube is attached to the bag valve and urine drains into a larger container while they sleep.

How often you change the pouch depends on the type you have. This can be every day, every few days, or even once a week.

To prevent urine from dripping onto your supplies, you may want to wait approximately 1 to 2 hours after drinking liquids to change the bag.

You can change the bag to any physical position, such as lying down or standing up, making it easy to see your stoma. Using a mirror can sometimes help.

Place your supplies on a clean surface and wash your hands well before changing the bag. You may want to use tissues or towels to absorb urine from the stoma while you are changing the bag.

Over time, your stoma size will stabilize and you can get pre-cut urostomy bags. In the period following surgery, the stoma may change in size, so you may need to measure and cut an opening in the bag yourself.

You do not need to eat or drink a special diet after urostomy surgery. You may find that your appetite is weak at first, but it’s a good idea to eat a healthy diet and drink plenty of fluids.

Although there is no specific diet with a urostomy, you may want to drink beverages and eat foods that keep your urine acidic.

Drinking plenty of water or other non-alcoholic liquids, at least 2 liters a day, can help achieve this goal. Acidic urine can help prevent urinary crystals from forming on the stoma or skin.

Since a piece of bowel is removed during urostomy surgery, you may experience changes in bowel movements. Your stools may be looser.

You don’t have to swim with your urostomy bag. If you remove it, try washing around the stoma using only water and drying the area well. This will help ensure that the bag adheres well to the skin when you put it back on.

Some people choose to clip or shave the hair from the skin around the stoma. This can help the bag stick well and can also make it less painful to remove.

If you shave the area, do it very carefully using a dry razor and ostomy powder. Rinse well and dry the skin after shaving.

Observe your skin under and around the pocket for sensitivities. A pocket blanket can help. You can also try different barriers and tape if they irritate your skin.

When removing a pocket, do so gently, pulling the skin away from the pocket and not the pocket away from the skin.

Your healthcare team or insurance company can help you find a place to order urostomy supplies.

Try to keep your supply in stock and order new items a few weeks before they run out, to account for shipping and possible delays.

You can do many of the same activities you did before your urostomy, including swimming. For these occasions, you can use a smaller bag and a waterproof bandage.

Ostomy pouches are designed to be discreet, so others won’t know you’re wearing one.

You don’t need to tell anyone about the urostomy if you don’t want to, but people often find close friends and family to be understanding when they do.

If you’re in a relationship and have had a urostomy, you may have concerns about your privacy.

Talking with your partner or a healthcare professional, as well as joining a support group with other people who have an ostomy, can help you manage these concerns.

If you are close to someone who has had a urostomy, you can be an important source of support and comfort.

Nevertheless, many partners find the experience difficult. You can talk alone or with your partner, a nurse or a urostomy counselor about your own feelings about what this means for your relationship.

Urostomy surgery can be an important treatment option for bladder cancer. The procedure can bring many changes to your life, but over time, many people adopt a urostomy management plan that supports their health and well-being.

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