A urostomy is a surgical procedure that creates an opening in the abdominal wall to divert urine away from the bladder when it can no longer function properly. This opening called a stoma, serves as a new pathway for urine to exit the body. A urostomy may be temporary or permanent, depending on the underlying medical condition and the patient's needs. Understanding what a urostomy is and why it’s performed can help patients and caregivers navigate this life-changing procedure with greater confidence and knowledge.
Why is a Urostomy Done?
A urostomy is performed for various medical reasons, often to address issues that affect the urinary system. Some common reasons include:
Bladder Cancer: In cases where the bladder is removed due to cancer, a urostomy is necessary to reroute urine.
Chronic Urinary Tract Infections (UTIs): Severe or recurrent infections may require a urostomy to protect the kidneys and urinary system.
Trauma or Injury: Damage to the bladder or ureters from accidents or surgery may necessitate a urostomy.
Neurological Conditions: Disorders such as spina bifida or multiple sclerosis can impair bladder function, making a urostomy necessary.
Congenital Conditions: Some individuals are born with defects in the urinary system that require surgical correction with a urostomy.
Radiation Damage: Radiation therapy for pelvic cancers can cause long-term damage to the bladder, leading to the need for a urostomy.
What Does a Urostomy Involve?
The Surgery
During the procedure, the surgeon:
Removes or bypasses the affected portion of the urinary system.
Creates a stoma by connecting a section of the small intestine (usually the ileum) to the ureters and bringing it through the abdominal wall.
Secures the stoma to the skin and ensures it is properly positioned for urine elimination.
The surgery typically requires a hospital stay and involves recovery time to allow the body to heal and adjust.
The Stoma
The stoma is a small, circular opening on the abdomen. It does not have nerve endings, so it is not painful. The stoma’s appearance may vary based on individual anatomy, but it is generally pink or red and moist. Since urine flows continuously, the stoma is connected to a collection system.
Urostomy Appliances
After the surgery, urine is collected in an ostomy pouch or bag that adheres to the skin around the stoma. These appliances are designed to be leak-proof, discreet, and comfortable. Modern urostomy products include:
Pouches with anti-reflux valves to prevent backflow.
Night drainage systems for convenience during sleep.
Accessories to help with skin care and pouch adherence.
Temporary vs. Permanent Urostomy
Temporary Urostomy: Often used to allow healing after surgery or injury. Once the urinary system recovers, a second surgery may be performed to reverse the urostomy.
Permanent Urostomy: Necessary when the bladder is permanently removed or when conditions severely impair its function.
Adjusting to Life with a Urostomy
Physical Recovery
After surgery, patients may experience fatigue and soreness as they heal. Healthcare providers typically offer guidance on how to care for the stoma, manage the pouch, and monitor for complications.
Emotional Adjustment
Living with a urostomy can bring emotional challenges. It’s natural to feel overwhelmed or self-conscious at first. Support groups, counseling, and connecting with others who have urostomies can help patients build confidence and adapt to their new normal.
Lifestyle Considerations
Patients with a urostomy can typically return to most of their usual activities, including work, exercise, and social events. Specific recommendations may include staying hydrated, emptying the pouch regularly, and protecting the stoma during physical activities.
A urostomy is a life-altering procedure that provides a solution for individuals with severe urinary system issues. While the adjustment can be challenging, modern medical advancements, support systems, and proper education make it possible to live a full and active life with a urostomy. If you or a loved one are preparing for this surgery, remember that you are not alone, and resources are available to guide you every step of the way.