A urostomy is an opening in the abdomen created by a surgical procedure (radical cystectomy) to allow urine to flow to the outside of the body. This may be needed when a diseased or damaged bladder has to be removed. Part of the ureters may also be removed. A small segment of the small or large intestine is used to create the channel (a urinary diversion).
Wound, ostomy, and continence nurses (WOCNs) are available in some medical centers to help you learn how to care for your ostomy. Talk with your surgeon about meeting with a WOCN after your surgery.
It takes time to adjust to having a urostomy. But you will be able to work, participate in sports and physical activities, be intimate with your partner, and resume your social life after surgery.
Immediately after your surgery, activities such as driving and lifting will be restricted to allow the stoma to heal. After 2 to 3 weeks, you should be able to resume normal activities. Noncontact activities, such as swimming, hiking, camping, and tennis, should be no problem. If you had an exercise routine, talk to your doctor about when you can restart it and whether it is possible to participate in contact sports, such as football, karate, and basketball, which could result in injury to the stoma.
Your work should not be affected. The only types of work that you may not be able to perform are those that require heavy lifting or physical contact. Talk with your doctor to learn about any occupational limitations you may need to know about.
Usually you will have no dietary restrictions and foods can be enjoyed as before. You should drink 8 to 10 glasses of fluid each day to help decrease the chance of kidney infection.
Many of the problems relating to intimacy may be more emotional than physical. You may be concerned with ability, body image, and what others think. Talk to your doctor, counselor, or a therapist for help coping with any problems concerning intimacy or your self-image.
You will probably be able to wear the same clothing. Tight clothes will not hurt your stoma. If you have trouble hiding your ostomy pouch, or if it shows through your clothing, your WOCN may have suggestions.
You can continue to travel. Empty or change your ostomy pouch before beginning your trip. When traveling by plane, bring extra ostomy supplies in your carry-on baggage, not checked baggage. If traveling by car, store your supplies in a cool place.
Caring for your ostomy
You want to keep your quality of life, and understanding how to care for your ostomy will help you live comfortably with it.
When you have an ostomy, urine leaves your body through the stoma instead of the urethra. Since there is no muscle around the stoma, you are not able to control when urine passes out of your body. An odor-proof plastic pouch (ostomy pouch) surrounds the stoma to collect the urine and is held to your skin with an adhesive. Pouching systems may be one-piece or two-piece.
Both two-piece and one-piece pouches can be either drainable or closed. These systems also contain a special valve or spout that adapts either to a leg bag or to a night drain tube connected to a special drainable bag or bottle.
Replacing your ostomy pouch
If you have a drainable pouch, you usually need to replace it every 4 to 7 days or whenever there is a leak in the pouch or itching or burning under the barrier. If you have a closed pouch, replace it when it is one-third to one-half full.
Treating skin irritation
The stoma is normally pink to red. Call your doctor if your stoma:
If the skin under your pouch is red, irritated, or itchy, you need to treat your skin. Follow these steps:
Ostomy accessories may include:
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