Urostomy

(Urinary Diversion Surgery)

Pronounced: Your-os-toe-me
by Deanna M. Neff, MPH

Definition

A urostomy is done to create an opening in the abdominal wall. The urinary system will also be rerouted so that urine can pass through this new opening. A tube will allow urine to pass from this opening to a bag outside the body. Sometimes an internal pouch is created using the intestine.

You should be able to return to normal activities after your urostomy.

The Female Urinary System

Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

A urostomy tube may be needed if urine is not able to pass through the urinary system. Most of the time a urostomy is needed because of problems with the bladder such as:.

  • Bladder cancer
  • Birth defects
  • Chronic inflammation
  • Nerve-muscle control problems

Possible Complications    TOP

Complications are rare, but no procedure is completely free of risk. If you are planning to have a urostomy, your doctor will review a list of possible complications, which may include:

  • Skin irritations
  • Fluid build-up in the abdomen
  • Urine flow blockage
  • Damage to other organs
  • Bleeding
  • Infection
  • Blood clots
  • Adverse reaction to the anesthesia such as light-headedness, low blood pressure, wheezing

Factors that may increase the risk of complications include:

What to Expect    TOP

Prior to Procedure

Your doctor will go over your family and medical history. You will also have a physical exam. Part of the exam may include tests, like:

  • Urine tests
  • Blood tests
  • Cystoscopy
  • MRI or CT scan
  • Urography

You may also need to:

  • Discuss any allergies or allergies to medications that you have.
  • Disclose what medicines, herbs, or supplements you take.
  • Know what paperwork you will need to bring with you.
  • Arrange for a ride from the hospital and help at home.
  • Do not eat or drink the night before your surgery.

You may be asked to stop taking some medicines up to one week before the procedure, like:

  • Aspirin and other anti-inflammatory drugs (such as ibuprofen and acetaminophen)
  • Blood-thinning drugs such as warfarin (Coumadin)
  • Anti-platelet drugs such as clopidogrel (Plavix)

Anesthesia

You will have general anesthesia. It will block pain and keep you asleep.

Description of the Procedure

An incision is made in the abdomen. A piece of intestine will be removed. The tubes that pass urine to the bladder will be detached from the bladder. The tubes are then reattached to the intestine that was removed. The other end of the intestine is then brought through the abdominal wall to form a stoma. One end is closed together to make a pouch that holds urine inside the body. The bladder may or may not be removed.

The abdomen will be closed. Stitches or staples will be used to close the skin.

Immediately After Procedure

Your breathing tube will be removed. You will be taken to the recovery room.

How Long Will It Take?

About 2-5 hours.

How Much Will It Hurt?

Anesthesia will prevent pain during the surgery. As you recover, you will have some pain. Your doctor will give you pain medicine to help you manage the discomfort.

Average Hospital Stay

You will be in the hospital for for a few weeks. Your doctor may keep you in the hospital longer if you have any complications.

Post-procedure Care

At the Hospital

At the hospital, you will:

  • Walk as soon as you are able to help prevent blood clots.
  • You will receive nutrition through an IV until your gastrointestinal tract is functioning again
  • Learn how to change the urine pouch and dispose of urine.

At Home

When you return home, take these steps:

  • Care for your stoma as directed.
  • Change your pouch on a regular schedule.
  • Avoid strenuous activity.
  • Avoid heavy lifting, straining, and sexual activity until you have fully recovered.
  • Do not drive until your doctor says that it is safe to do so.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • When it is okay to get the stoma wet, do not use bath oils or salts in the water.
  • Be sure to follow your doctor's instructions.

Call Your Doctor    TOP

Call your doctor if any of these occur:

  • Fever or chills
  • Nausea or vomiting
  • Pain that you cannot control with the medicines you have been given
  • Unusual discharge such as pus, extreme cloudiness, or strong odor
  • Redness, swelling, or excessive bleeding from the stoma site
  • Unusual changes in stoma size or color
  • Change in or no urine output
  • Back or abdominal pain
  • Cough, shortness of breath, or chest pain

If you have an emergency, call for medical help right away.

RESOURCES:

American Cancer Society
http://www.cancer.org/
United Ostomy Association of America
http://www.uoaa.org/

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca/
Canadian Urological Association
http://www.cua.org/

References:

Bladder cancer. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what. Updated January 22, 2013. Accessed February 12, 2013.
Urostomy a guide. American Cancer Society website. Available at: http://www.cancer..... Updated March 17, 2011. Accessed February 12, 2013.
Urostomy guide. United Ostomy Associations of America website. Available at: http://www.ostomy.org/ostomy_info/pubs/UrostomyGuide.pdf. Updated 2011. Accessed February 12, 2013.
Last reviewed February 2013 by Adrienne Carmack, MD
Last Updated: 2/13/2013