What is a urostomy?
A urostomy is a stoma formed to divert the normal flow of urine from the kidneys and ureters. To create the stoma, the surgeon will isolate a short piece of small bowel from which a tube or spout (known as an ileal conduit) will be fashioned. The two ureters (the ducts by which urine passes from the kidney to the bladder) will be plumbed into this spout which will be brought to the surface of the abdomen and sutured to the skin. Urine will pass through the stoma, completely bypassing the bladder and leaves the body through a tube before being collected in a urostomy bag or urine drainage bag. The bladder may be removed in a procedure known as a cystectomy or may remain within the body, however a urostomy is permanent.
Why might somebody need a urostomy?
There are a number of reasons for a urostomy due to disease or damage to the bladder or urinary system and may have to endure frequent infections if the urine is forced back into the kidneys. Babies are sometimes born with a defect of their urinary system. In adults, neurological disorders leading to severe incontinence or bladder cancer may result in urostomy surgery. For other types of urinary incontinence, urology products such as catheters and continence devices may be more appropriate solutions.
How the urinary system normally works
The urinary system comprises:-
- Two kidneys – filter blood and remove waste products and excess water
- Two ureters – tubes which connect the kidney to the bladder
- One bladder – reservoir for urine
- One urethra – tube connected to bladder which expels urine.
- Urine is produced in the kidneys (approximately 2 litres per day). It is then carried down long tubes called ureters to the bladder where it is stored. Urine flows continually into the bladder from the ureters and during the course of a normal day the bladder will gradually fill. Once it is approximately half full the first sensation of wanting to pass urine occurs and the bladder will contract and squeeze out the urine via the urethra. In healthy adults this process of urination is under voluntary control.
Waste from a urostomy
The flow of urine from a urostomy is continuous and a urostomy bag with a tap will be worn which will need emptying several times per day. The urine may contain some mucus as it has been formed from small bowel which is a mucous membrane. The urostomy bag may be attached to a night drainage bag at night time and the bag will be changed every few days according to personal preference.
Caring for your urostomy
For help, support and advice to suit your specific situation, ask your stoma care nurse in the first instance. They are likely to visit you before your operation to teach you how to apply your urostomy bag or drainage kit and talk through the various urostomy products and routines. Before you leave the hospital, you should be supplied with the equipment you need for caring for your urostomy at home and your stoma care nurse can also sign you up to a pharmacy or home delivery service to ensure regular deliveries of your urostomy supplies.
Once you are back home, you may be visited by the stoma care nurse to check you are adapting to life with a urostomy well and managing your urostomy bag changes. They will be able to answer any questions you have and help deal with any issues you are facing.
If you do not have a stoma care nurse, you are welcome to call our freephone Careline team for support, on 0808 1596 017.