Urostomy

(Urinary Diversion Surgery)

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

Definition

An ostomy makes an opening in the belly wall. A urostomy allows urine to pass to a bag outside of the body. An internal pouch can also be created using the intestine.

Once healed, a urostomy shouldn’t limit your activities.

The Female Urinary System

Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

A urostomy is needed if urine can’t pass through the urinary system as normal. You may need one because of:

  • Bladder cancer
  • Structural defects—some may have existed since birth
  • Long term inflammation
  • Nerve or muscle problems

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review possible problems such as:

  • Irritated skin
  • Fluid buildup in the belly
  • Blocked urine flow
  • Organ damage
  • Bleeding
  • Infection
  • Blood clots

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of problems such as:

What to Expect

Prior to Procedure

Your doctor may do:

You may also need to:

  • Talk to the doctor about the medicines you take. You may need to stop certain medicines up to 1 week in advance.
  • Arrange for a ride home.
  • Arrange for help at home.
  • Not eat or drink the night before your surgery.

Anesthesia

General anesthesia will block pain and keep you asleep.

Description of the Procedure

An incision is made in the belly to access the area. There are several ways to create a new path for the urine to flow. Your doctor will discuss the options with you.

Most methods require a stoma. A stoma is an opening made through the belly wall. A small section of small or large intestine will be removed. It will be used to make a path between the ureters and the stoma. Ureters are tubes that carry urine from the kidneys to the bladder. There are 2 main types:

  • Conventional—The intestine is shaped like a tube. It allows urine to flow freely from the stoma into an external bag.
  • Continent—The intestine is shaped like a pouch. This will let you store the urine in your body until you drain it with a special tube called a catheter.

A third type, called a neobladder, doesn’t need a stoma. A pouch is made from the small intestine. The ureters and urethra (the tube that carries urine out of the body) are connected to it much like the original bladder. Urine can then pass from the body like it did with the bladder.

The incisions are closed with stitches and bandaged.

Immediately After Procedure

The healthcare staff will watch vital signs while you wake up.

How Long Will It Take?

About 2-5 hours.

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Medicines will help ease pain after.

Average Hospital Stay

You will be in the hospital for a few days. You may need to stay longer if you have problems.

Post-procedure Care

At the Hospital

The healthcare staff will help you:

  • Lower the risk of blood clots by having you walk around
  • Get IV nutrition while your intestines heal
  • Learn how to change the ostomy bag—conventional
  • Learn how to use a catheter to empty the internal pouch—continent
  • Learn how to take care of the stoma

During your stay, the healthcare staff will take steps to lower your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your chance of infection such as:

  • Washing your hands often and reminding your healthcare staff to do the same
  • Reminding your healthcare staff to wear gloves or masks
  • Not allowing others to touch your incision

At Home

When you return home:

  • Care for your stoma as advised.
  • Change the bag at regular times.
  • When it is okay to get the stoma wet, do not use bath oils or salts in the water.
  • Take care of the wound.
  • Watch for signs of infection.

Call Your Doctor

Call your doctor if any of these occur:

  • Fever or chills
  • Persistent nausea or vomiting
  • Pain that you cannot control with the medicines you were given
  • Pus, cloudiness, or strong odor in your urine
  • Redness, swelling, or bleeding from the stoma site
  • Unusual changes in stoma size or color
  • Change in amount or frequency of passing urine
  • Back or belly pain
  • Cough, breathing problems, or chest pain

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

RESOURCES:

American Cancer Society
https//www.cancer.org
United Ostomy Associations of America
https://www.ostomy.org

CANADIAN RESOURCES:

Canadian Cancer Society
https://www.cancer.ca
Health Canada
https://www.canada.ca

References:

Bladder cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115106/Bladder-cancer . Updated May 31, 2017. Accessed June 15, 2018.
Urostomy guide. United Ostomy Associations of America website. Available at: https://www.ostomy.org/wp-content/uploads/2018/03/UrostomyGuide.pdf. Accessed June 15, 2018.
Last reviewed May 2018 by EBSCO Medical Review Board Adrienne Carmack, MD
Last Updated: 6/15/2018

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