Urostomy Home Guide

A urostomy is an opening for urine to leave your body when you have had your bladder removed. During a surgery, the tubes that drain urine from your kidneys are connected to a piece of intestine. This piece of intestine is then brought through a hole in the abdominal wall. This new opening is called a stoma or ostomy. A bag or pouch fits over the stoma to catch your urine.

CARING FOR YOUR STOMA

Normally, the stoma looks a lot like the inside of your cheek: pink and moist. At first, it may be swollen, but this swelling will decrease within 6 weeks.

Keep the skin around the stoma clean and dry. You can gently wash your stoma and the skin around your stoma in the shower with a clean, soft washcloth. If you develop any skin irritation, your caregiver may give you a stoma powder or ointment to help heal the area. Do not use any products other than those specifically given to you by your caregiver.

Your stoma should not be uncomfortable. If you notice any stinging or burning, your pouch may be leaking, and the skin around your stoma may be coming into contact with urine. This can cause skin irritation. If you notice stinging or leaking of any amount, replace your pouch with a new one and discard the old one.

UROSTOMY POUCHES

The pouch that fits over the urostomy can be made up of either 1 or 2 pieces. A one-piece pouch has the skin barrier piece and the pouch itself in one unit. A two-piece pouch has a skin barrier with a separate pouch that snaps on and off of the skin barrier. Either way, you should empty the urostomy when it is only ⅓ to ½ full. Do not let more urine build up. This could cause the pouch to leak.

If you are concerned with odor, ask your caregiver about ostomy deodorizer solutions you can use in the urostomy bag.

EMPTYING YOUR UROSTOMY POUCH

You may get lessons on how to empty your pouch from a wound-ostomy nurse before you leave the hospital. Here are the basic steps:

  • Wash your hands with soap and water.

  • Open the valve on the tail end of the pouch.

  • Allow the bag to drain into the toilet.

  • Close the valve and dry it.

  • Wash your hands again.

AT NIGHT

You may need to set an alarm to get up a couple of times each night so that your pouch does not become too full. Otherwise, you may prefer to connect your pouch to a larger drainage system. If you use one of these larger systems, you will need to clean it carefully after each use:

  • Wash your hands with soap and water.

  • After emptying the drainage system in the morning, wash it with warm soapy water and rinse it carefully.

  • Hang it up to dry for the day.

  • Make a 1 to 1 water and vinegar mixture. Use this to clean the drainage system once a week.

  • Keep a cap on the end of the tube when you are not using it. This is to keep the system clean.

  • If the system  cracks or starts to leak, replace it with a new system.

  • Wash your hands again.

CHANGING YOUR UROSTOMY POUCH

Change your urostomy pouch about every 3 to 4 days for the first 6 weeks, then every 5 to 7 days. Always change the bag sooner if you begin to notice any discomfort or irritation of the skin around the stoma. A wound-ostomy nurse may teach you how to change your pouch before you leave the hospital. Here are the basic steps:

  • Lay out your supplies.

  • Wash your hands with soap and water.

  • Carefully remove the old pouch.

  • Wash the stoma and allow it to dry. Men may be advised to shave any hair around the stoma very carefully. This will make the adhesive stick better.

  • Use the stoma measuring guide that comes with your pouch set to decide what size hole you will need to cut in the skin barrier piece. You want to choose the smallest possible size that will hold the stoma but will not touch it.

  • Use the guide to trace the circle on the back of the skin barrier piece. Cut out the hole.

  • Hold the skin barrier piece over the stoma to make sure the hole is the correct size.

  • Remove the adhesive paper backing from the skin barrier piece.

  • Clean and dry the skin around the stoma again.

  • Carefully fit the skin barrier piece over your stoma.

  • If you are using a two-piece pouch, snap the pouch onto the skin barrier piece.

  • Close the tail of the pouch.

  • Put your hand over the top of the skin barrier piece to help warm it for about 5 minutes, so that it conforms to your body better.

  • Wash your hands again.

DIET TIPS

  • Drink about eight 8 oz glasses of water each day.

  • You can continue to follow your usual diet, although some foods cause the urine to have a strong odor. You may want to cut back on some of these foods, such as:

  • Asparagus.

  • Fish.

  • Eggs.

  • Cheese.

  • Coffee.

  • Garlic.

  • Spicy foods.

  • Medicines can also contribute to odor, including:

  • Vitamins.

  • Antibiotic medicine.

GENERAL TIPS

  • It is normal to notice some mucus in your urine.

  • You can shower with or without the bag in place.

  • Always keep the bag on if you are bathing or swimming.

  • If your bag gets wet, you can dry it with a blow-dryer set to cool.

  • Avoid wearing tight clothing directly over your stoma so that it does not become irritated or bleed. Tight clothing can also prevent the urine from draining into the pouch, which can cause it to leak.

  • It is helpful to always have an extra skin barrier and a pouch with you when traveling. Do not leave them anywhere too warm, as parts of them can melt.

  • Do not let your seat belt rest on your stoma. Try to keep the seat belt either above or below the stoma, or use a tiny pillow to cushion it.

  • You can still participate in sports, but you should avoid activities in which there is a risk of getting hit in the abdomen.

  • You can still have sex. It is a good idea to empty your pouch prior to sex. Some people and their partners feel very comfortable seeing the pouch during sex. Others choose to wear lingerie or a T-shirt that covers the device.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You notice a change in the size or color of the stoma, especially if it becomes very red, purple, black, or pale white.

  • You have cloudy, bad smelling urine.

  • You have increased amounts of mucus in the urine.

  • You have bloody urine.

  • You have back pain.

  • You have abdominal pain, nausea, vomiting, or bloating.

  • There is anything unusual protruding from the urostomy.

  • You have irritated or red skin around the urostomy.