Preparing for a urostomy is very important. There are many different aspects to consider and you may notice an increase in appointments and consultations with your healthcare team as you prepare for surgery. . With the correct preparation, the whole process does not have to feel daunting.  With this urostomy guide, you can take the first steps to understand this procedure. 

What is a urostomy?

One of the most common surgeries used to treat bladder cancer is called a urostomy. Surgeons perform this surgery when your bladder has been removed through a cystectomy or if there is bladder dysfunction.

During the operation, the surgeon will make an opening through your abdominal wall called a stoma. The doctor will then use a portion of your intestine for urine to pass through the stoma instead of going through the urethra.

A urostomy is different from an ileostomy or colostomy. An ileostomy or colostomy are different types of ostomies where surgeons create an opening in your abdomen to redirect either stool.

Who needs a urostomy surgery?

If you were born with a congenital disability such as spina bifida (a condition affecting the spinal cord) resulting in severe bladder difficulties, you might need urostomy surgery. People with bladder cancer may also need a urostomy to remove a section of or their whole bladder. The surgeon will have to redirect the flow of urine since the bladder was removed.

Bladder disorders frequently result in persons being unable to regulate the flow of urine. It can be stressful, and continuous moisture on the skin caused by unintentional bladder leaks can cause significant difficulties.

Types of urostomies

There are two types of urostomies: standard or conventional urostomy and continent urostomy. The two types are named after how the pathway where urine passes from the body is rerouted during surgery.

A surgeon performs a standard urostomy by removing a segment of the small intestine and connecting it to the ureters and the outside of the abdomen. The urine then runs down this new tube, known as an ileal conduit, and out through the stoma, where it is collected in a pouching system.

Continent urostomy, on the other hand, involves creating a pouch to retain urine. The pouch has valves on both ends to prevent urine from backing up into the kidneys and causing leakage. You’ll then insert a catheter into the stoma to empty the urine.

How do you prepare for a urostomy surgery?

Important note: remember, the following is only meant to provide a general overview of what your experience might be like. Experiences can vary and you should always turn to your doctor for specific information for your situation.

Thirty days prior to surgery, the healthcare team will conduct tests to ensure that you’re in good health. These might include:

  • blood tests
  • electrocardiogram (EKG)
  • chest X-ray
  • ultrasound

You will also meet with a pre-operative nurse to review your medical and surgical history. The nurse will also explain which medications to take the morning of your surgery. It is helpful for the healthcare team if you bring the following to your appointment:

  • A current list of the medications you’re taking, including over-the-counter and prescription medicine
  • Any tests performed prior to the appointment, such as a cardiac stress test, carotid doppler study, or echocardiogram
  • The name and number of your doctor

One week prior to your surgery, you might be provided with instructions for taking aspirin. If you are already taking aspirin or medicine that contains aspirin, you may need to adjust your dose or discontinue it. You should also stop taking vitamin E, multivitamins, dietary supplements, and herbal remedies. Remember: always defer to your doctor before following any other advice.

Two days prior to surgery, you should stop taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen. All of these can cause bleeding.

If you have diabetes, you should consult your diabetic specialist about what you should do while on a liquid diet. If you are taking diabetic medication such as insulin, you may ask the doctor to adjust your dosage before undergoing a urostomy.

Inquire whether you should consume sugar-free drinks. Make sure to monitor your blood sugar levels often, and don’t forget to consult a healthcare professional if you have any queries.

Your surgeon might also advise you not to consume anything after midnight. You may also have to shower and wash with antibacterial soap the night before your procedure.

What happens during the surgery?

First, you will be given general anesthesia, which will put you to sleep and keep you from experiencing any discomfort during the surgery. The surgeon will then remove a small section of your intestine called the ileum. The remainder of your intestine will be reconnected, allowing you to resume regular bowel movements.

The ileum is connected to your ureters on one end and the stoma on the other. The urine will then be routed from your ureters via the ileum to a pouching system that you will wear outside of your body.

You should also be aware of the potential risks of the procedure. This will be discussed with the surgeon prior to surgery. Potential risks include:

  • Complications with general anesthesia
  • Infection
  • Blood clots or bleeding
  • Injury to other parts of the body or organs
  • Scar tissue in the intestines causing a blockage
  • Changes in bowel function

You should immediately call your doctor or ostomy care nurse if you notice the following symptoms:

  • Excessive bleeding from the stoma
  • Skin sores
  • Extreme changes in stoma size
  • Black, white, or purple stoma
  • A strong odor emanating from the stoma
  • Bulge or pain in your stomach
  • Fever
  • Bloody or foul-smelling urine

What should I expect during recovery?

Important note: remember, the following is only meant to provide a general overview of what your experience might be like. Experiences can vary and you should always turn to your doctor for specific information for your situation.

After your procedure, you will need to stay in the hospital for a few days up to a week. You’ll have a drain in place initially to remove fluid from your abdomen.

You may be unable to eat solid food for several days, so you may need to receive nutrition intravenously (IV), this is called total parenteral nutrition (TPN).

Your ostomy nurse will educate you on wearing the pouch and caring for your surgical incisions and stoma before leaving the hospital. You will also receive pain medicine.

Although you will be able to walk, you should avoid strenuous activities and lifting heavy things to avoid complications for about a month. If you experience any complications, immediately contact your doctor and prioritize recovery.

How successful is a urostomy surgery?

A urostomy can change your life. If your bladder has been removed or is damaged, this procedure will allow your body to remove urine again, so you can resume your daily activities.

You’ll have to wear a pouch outside of your body if you have a urostomy. You won’t be able to urinate regularly as you would after continent urinary diversion surgery.

To maximize your preparations for urostomy surgery, it is best to consult your healthcare team. You can also contact Better Health, a patient-centered healthcare provider, for personalized and real-time assistance with your concerns. Call 415-475-8444 or visit today.

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