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Understanding issues that may arise with a urostomy

The idea of having a urinary diversion can be a bit daunting. You’ll be pleased to know that after an operation to form a urostomy, many people have few or no problems whatsoever. However, some do experience difficulties, and we hope that this information helps you understand some of the issues that may occur.

You are entitled to impartial advice on the urostomy pouches most suited to your needs. We recommend that you discuss this with your stoma nurse.

Bacteria are commonly present in a urostomy, but are usually flushed away if you drink plenty (approximately two to three litres per day). You may need antibiotics if you become unwell with any of the following symptoms – cloudy, offensive smelling wee, accompanied by discomfort or pain around the stoma or kidney area and a raised temperature. Speak to your GP or stoma nurse, who will probably send a specimen of your wee to be analysed so that the appropriate antibiotic can be prescribed.

Taking a specimen of wee directly from your stoma, using a sterile catheter, is the ideal way of collecting a non-contaminated specimen. If this is not possible you should clean you stoma and a hold a specimen container just below it to collect drops of wee. A urine specimen to detect infection must NEVER be taken from a urostomy pouch which has been on for some time, as it will contain stale urine and give a false result.

A hernia is a weakness in the abdominal wall at a site where the abdomen has been opened surgically. This can occur either around the stoma or at the incision site, and a small bulge develops. A hernia support belt can be worn, to help prevent a hernia developing, or to support an existing hernia.

Discuss any concerns you may have with your stoma nurse. Surgical correction is only advised if your hernia is causing great discomfort or obstruction. Mesh may be inserted at the time of the operation to repair the hernia to strengthen the abdominal wall, as recurrent surgery may weaken the abdominal wall further.

One of the causes of stones is recurring urinary tract infection, so increase your fluid intake as a preventative measure. If you do pass a stone, save it and give it to your GP who can arrange to have it analysed.

Your stoma has many tiny blood vessels, so it is not unusual to see specks of blood when cleaning it. This is quite normal. Bleeding may also occur if your urostomy pouch is rubbing against your stoma, so take care as ulceration of your stoma may develop.

If you find your bleeding is excessive, seek medical help as soon as possible, as one of your large blood vessels may have been damaged. If the bleeding is coming from inside your stoma, do get this investigated urgently. Sometimes urine infections, and stones, can cause slight bleeding.

You are likely to be able to enjoy a completely normal diet. You may find it helpful to create an acidic urine PH to help prevent infection. You can do this by drinking cranberry juice or take cranberry capsules (unless you’re taking Warfarin), similarly any fruit juice and bio or live yoghurt are excellent. The top tip, however, is to drink lots of water.

  • To avoid an airlock in your night drainage system, connect your night drainage bag to a urostomy pouch with a quantity of urine in it. Squeeze the urine through into the night drainage bag and the urostomy pouch should then remain empty overnight.
  • You should wash your reusable night drainage bags thoroughly after each use. You can insert vinegar or disinfectant, using a syringe or small funnel, and then agitate and flush through with warm water. However, you can just use water. You should only use your night drainage bag for five to seven nights before replacing it with a new one.
  • You may find that the simplest method of night drainage is to use disposable bags, which you can empty and destroy after each use. Bags can be a little awkward to tear (to empty them) if you’ve got dexterity difficulties.
  • To avoid twisting of night drainage bags during the night, you may want to use an anti-twist strip, fastening the tube of the bag to your leg.
  • You may find that the need for a night drainage bag can be eliminated entirely whilst at home by using the U-Drain system. Speak to your stoma nurse about this.
  • Some people find a leg bag more convenient than a night drainage bag for additional capacity.
  • You may want to explore flat pack night drainage stands. These can be either free-standing or slid between the mattress and the base of the bed, and they are ideal for travel.
  • You might want to put the night drainage stand in a plastic bowl or inside a large plastic bag (ensuring there are no holes in the bottom) for extra security.

For details arise with a urostomy of products mentioned contact your specialist nurse or stoma equipment supplier.

Always keep a night drainage bag in the glove compartment of your car to empty your pouch into when held up in traffic. However, we don’t recommend that a full urostomy pouch, fitted with an emptying bung, rather than an open/closed tap, is emptied this way.

To make seat belts more comfortable over your stoma, you may prefer to use one of the following devices:

  • A cam plate allows your seat belt to be locked in a comfortable position,
  • but will release instantly when required.
  • A clip designed to lower the position of the seat belt, which is particularly
    useful for shorter people, where the diagonal would cross the neck
  • A simple sleeve addition to the belt for people who cannot reach the top
    anchorage point
  • device designed to ease belt tension across your chest and reduce any
    restriction in breathing, which can also reduce pressure on the abdomen.

These devices are available from good car accessory shops. You may also like to see our Directory of suppliers.

When flying on long journeys, if you are concerned that your pouch will overfill and you cannot easily access the plane toilets, connect a night drainage bag concealed in a bag, which you can then discreetly empty later.