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. The urostomy (or ostomy) creates an opening that is called a stoma.
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 an ostomy nurse after your surgery.
It takes time to adjust to having a urostomy. But with time after surgery, you will be able to work, participate in sports and physical activities, be intimate with your partner, and resume your social life.
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. With your pouch in place, you can still swim, hike, camp, and play tennis. Contact sports may cause injury to the stoma or may cause the pouch to slip. But check with your doctor about how to be safe while being active, whether it is playing sports or doing your exercise routine.
As your strength returns, you will likely be able to return to work. 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. Be sure to drink plenty of fluids each day to help reduce the chance of kidney infection.
A urostomy can affect a man's ability to have sex (usually just for a short time). Usually a woman's sexual ability isn't affected. If you are concerned about sex, your body image, and what others think, talk to your doctor, counselor, or a therapist. He or she can help you cope with problems concerning intimacy or your self-image.
You will probably be able to wear much of your same clothing. You'll want to avoid tight clothing that might cause problems with the drainage tube. And wearing looser pants can make it easier to conceal the pouch. Cotton knit or stretch underpants can provide support and keep the pouch secure. Your ostomy nurse will be able to help you with more clothing ideas.
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
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.
Understanding how to care for your ostomy will help you live comfortably with it. An ostomy nurse is a great support. He or she will help you learn to manage your ostomy so you can get back to a normal life. This will include learning how a pouch system works and how to replace your ostomy pouch. Your nurse will also give you tips on how to treat and prevent common problems, such as irritated skin.
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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