A urostomy is a procedure that reroutes the urine from the bladder to a surgically created opening on the surface of the abdomen called a stoma. As a result, urine from the kidneys, which passes through the ureters, will now flow out of the stoma and into an external pouch called a urostomy bag.
This surgery is usually recommended for people with nonfunctioning bladders and other similar conditions. Read on to learn more about urostomies and have a clearer understanding of what happens before and after the operation.
What happens during urostomy surgery?
This is what happens during urostomy surgery, which typically takes three to six hours:
- The surgeon removes a small section of the ileum or the small intestine.
- The intestines are reconnected to function as usual.
- The section of the ileum that is removed is used to create an ileal conduit, which is a new passageway that diverts urine.
- The ureters are disconnected from the bladder and attached to the ileal conduit.
- Sewn together is the end of the ileal conduit that is connected to the ureters. The other is brought to the surface of the abdomen to form the stoma, and this is where urine exits.
Why do you need a urostomy?
Serious bladder issues that prevent the proper functioning of the urinary system may require a urostomy. If your bladder is injured, no longer working, or has been removed, then you’ll most likely need a urostomy. This life-saving procedure also improves the quality of life of individuals and allows them to continue enjoying their favorite activities.
People with the following diseases or conditions may require a urostomy:
- Bladder injury or trauma
- Bladder cancer
- Urinary incontinence
- Urinary tract congenital disabilities
- Damaged nerves that control the bladder
- Chronic bladder inflammation
- Spinal cord injury
Preparing for urostomy surgery
- Pre-surgery tests
Before the surgery, your doctor and nurse will talk you through how to get ready and what to expect from the procedure. Preparations may include taking tests such as a chest X-ray, electrocardiogram (ECG), and blood tests to ensure that it’s safe for you to undergo a urostomy.
When providing your medical and surgical history, be sure to inform your doctor and nurses of all the medications and prescriptions you’re currently taking. They’ll advise you of which medicines you should and shouldn’t take before and on the day of the surgery.
You should also let your health care providers know if you drink or smoke. Stopping drinking and smoking or even reducing alcohol intake and cigarettes before your surgery can help lower your risk of complications and improve your recovery time after urostomy surgery.
- Stoma site identification
Your medical team will then meet with you to identify the best spot on your belly to place the stoma. This area should be easy for you to reach, so you’ll have no trouble changing your pouch and caring for your stoma.
Its location should also suit your lifestyle and activities, so you and your team should make sure that you can comfortably reach your stoma in order to keep it clean and change your urostomy bag. To ensure the correct spot is found for your stoma, you might be asked to wear a sample pouch to see which area of the urostomy bag will stay flat as much as possible, away from folds, creases, or any scars.
- One day before your urostomy surgery
You might need to go on a liquid diet before surgery and you’ll likely be prohibited from eating anything after midnight. Your doctor or nurse will also inform you whether any bowel preparation is required.
A good night’s sleepwill help you stay well-rested and ready for the surgery. You should also take a shower and wash your belly using an antibacterial soap or antiseptic skin cleanser to help reduce your risk of getting an infection.
Recovery and living with a urostomy bag
A urostomy is an inpatient procedure, so you’ll likely have to stay at the hospital after surgery. You won’t be able to eat solid foods while recovering and will be fed intravenously or through a tube in your vein. Physical activities will be limited and heavy lifting isn’t allowed.
It’s normal for your stoma to swell after surgery; this will gradually reduce until it reaches its final size. You might also notice the stoma producing mucus, which will appear as a whitish, jelly-like substance in the urine.
Right after your operation, urine will begin to flow to the pouch. It can initially be pink or red but will eventually return to its normal yellow color after a few days. Your groin area might also experience some swelling, and your genitals might have some discharge. Do not worry, as these are all normal and will go away over time.
Learning, adapting, and adjusting
As you heal and recuperate, you’ll be taught how to drain your urostomy bag, how often you need to change it, and the proper way of changing it to avoid leaks, odors, and skin irritations. Do remember that it might take time for you to adjust to life with a urostomy bag. But once you do, you can go back to your routine, live comfortably, and even thrive.
Living with a urostomy bag need not limit you in any way—you can still wear anything you want (without the bag showing) and do anything you wish to (except for heavy lifting), including playing sports and swimming.
Please be advised that some doctors don’t recommend contact sports because of the possibility of injuring the stoma. If unavoidable, special protection can be used, such as wearing a guard or belt.
What you need as an ostomate
Ostomates, or individuals who have undergone a colostomy, ileostomy, or urostomy, need specific appliances or a pouching system for their day-to-day life. Better Health can help you choose one that suits you best.
Apart from urostomy supplies, it’s also important to have access to useful and relevant information and support. You can find a wide range of resources for ostomates at https://joinbetter.com, from diet tips to personalized advice, and more! Join our ostomy community today!