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Urostomy

(Urinary Diversion Surgery)

Definition

A ostomy creates an opening in the abdominal wall. A urostomy reroutes urine so that urine can pass through this new 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
IMAGE
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

A urostomy 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

v
  • Skin irritations
  • Fluid build-up in the abdomen
  • Urine flow blockage
  • Damage to other organs
  • Bleeding
  • Infection
  • Blood clots
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

What to Expect

Prior to Procedure

Your doctor will go over your family and medical history. A physical exam will be done. 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.
  • Tell your doctor about any medications, 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 medications up to one week before the procedure, like:
  • Anti-inflammatory drugs
  • Blood thinners
  • Antiplatelets

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 surgery. Pain and discomfort after the procedure can be managed with medications.

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.
  • Receive nutrition through an IV until your gastrointestinal tract is functioning again
  • Learn how to change the urine pouch and dispose of urine.
  • Learn how to take care of the stoma
Preventing Infection
During your stay, the hospital staff will take steps to reduce 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 reduce your chance of infection, such as:
  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision
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

Call your doctor if any of these occur:
  • Fever or chills
  • Persistent nausea or vomiting
  • Pain that you cannot control with the medications 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 urine frequency or amount
  • Back or abdominal pain
  • Cough, shortness of breath, or chest pain
If you think you have an emergency, call for medical help right away.

RESOURCES

American Cancer Society http://www.cancer.org

United Ostomy Associations 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. Updated May 14, 2013. Accessed July 29, 2013.

Urostomy a guide. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/002931-pdf.pdf. Updated March 17, 2011. Accessed July 29, 2013.

Urostomy guide. United Ostomy Associations of America website. Available at: http://www.ostomy.org/ostomy%5Finfo/pubs/UrostomyGuide.pdf. Updated 2011. Accessed July 29, 2013.

Revision Information

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